NPI 1265636708
Iowa Dermatology Institute, P.C.
Practice location
- Address
- 2315 Roosevelt St, Clinton, IA 52732-2412
- Phone
- (563) 242-3571
- Fax
- (563) 243-4971
- Mailing address
- 4909 N Glen Park Place Rd, Peoria, IL 61614-4676
Authorised official
- Name
- Carl W. Soderstrom
- Title
- Physician
- Phone
- (309) 674-7546
Registered specialties (7)
Surgery of the Hand (Plastic Surgery) Physician
Primary
Dermatology Physician
MOHS-Micrographic Surgery Physician
Dermatopathology Physician
Procedural Dermatology Physician
Plastic Surgery Physician
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Registry record
- NPI
- 1265636708
- Entity type
- Organization
- NPI issued
- 11 Jun 2007
- Record last updated
- 11 Sep 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.