Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 00793 | IA |
NPI | 1023060225 |
---|---|
Provider Name | Dr. Phillip J Greenfield |
First Address | Clarion, IA 50525-2019 |
Second Address | Clarion, IA 50525-2019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 07/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0298471 | IOWA MEDICAID GROUP (01) | IA |
0491845 | (05) | IA |
18328 | WELLMARK BCBS OF IOWA (01) | IA |
I7688 | MEDICARE GROUP (01) | IA |
V09390 | (02) | IA |