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KEVIN J LIUDAHL MD PC NPI 1417098658


NPI Information

NPI: 1417098658
Provider Name: KEVIN J LIUDAHL MD, PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2800 PIERCE ST
SUITE 101
SIOUX CITY, IA
ZIP 51104
Phone: (712) 224-8677
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KEVIN J LIUDAHL MD, PC is a specialist in Sioux City, IA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. KEVIN J LIUDAHL MD, PC NPI is 1417098658. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2800 PIERCE ST
SUITE 101
SIOUX CITY, IA
ZIP 51104-755
Phone: (712) 224-8677
Fax: (712) 277-1662

The provider's authorized official is Kevin J Liudahl .
The authorized official title is President and has the following contact phone number (712) 224-8677.

The enumeration date for this NPI number is 2/9/2007 and was last updated on 11/13/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist25978IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10464826MEDICAIDIOWA
25796280001MEDICARE NSCIOWA
3I15532MEDICARE ID-TYPE UNSPECIFIEDIOWA
4A03402MEDICARE UPINIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.