Provider Demographics
NPI:1245882497
Name:THE IOWA CLINIC EXECUTIVE HEALTH
Entity type:Organization
Organization Name:THE IOWA CLINIC EXECUTIVE HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BARP
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:515-875-9255
Mailing Address - Street 1:5950 UNIVERSITY AVE STE 321
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8289
Mailing Address - Country:US
Mailing Address - Phone:515-875-9855
Mailing Address - Fax:515-875-9856
Practice Address - Street 1:5950 UNIVERSITY AVE FL 3
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8216
Practice Address - Country:US
Practice Address - Phone:515-875-9855
Practice Address - Fax:515-875-9856
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE IOWA CLINIC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-09
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty