Basic Information
| Provider Information | |||||||||
| NPI: | 1982248423 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | IOWA SPECIALTY HOSPITAL - CLARION | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | WEBSTER CITY CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1316 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CLARION | ||||||||
| State: | IA | ||||||||
| PostalCode: | 505252019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5155322811 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1924 SUPERIOR ST | ||||||||
| Address2: | |||||||||
| City: | WEBSTER CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 505953146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5158323332 | ||||||||
| FaxNumber: | 5158321114 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2019 | ||||||||
| LastUpdateDate: | 03/02/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SIMONIN | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5155329333 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.