Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

State University of Iowa

Organization Pediatrics Physician · NPI 1063802791

State University of Iowa provides Pediatrics Physician services in North Liberty, Iowa. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

1765 Lininger Ln
North Liberty, IA 52317-2316 Not confirmed with CMS for 11 years — call before visiting
Phone: (319) 467-7888
Fax: (319) 467-7889
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1063802791
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Philip Roudabush — Director, Patient Financial Service · (319) 384-2334
Other names University Of Iowa Children'S Hospital Gen Pediatrics-North Liberty
NPI enumeratedFebruary 3, 2015
Last updated in NPPESFebruary 19, 2015
Mailing address1765 Lininger Ln, North Liberty, IA 52317-2316

Other providers in North Liberty