Provider Demographics
NPI:1578656609
Name:KARMA PETERSON SLOOP OD PC
Entity type:Organization
Organization Name:KARMA PETERSON SLOOP OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARMA
Authorized Official - Middle Name:BIRGITTA
Authorized Official - Last Name:SLOOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-551-5114
Mailing Address - Street 1:603 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349-1693
Mailing Address - Country:US
Mailing Address - Phone:319-551-5114
Mailing Address - Fax:
Practice Address - Street 1:2801 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2757
Practice Address - Country:US
Practice Address - Phone:319-545-6419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2133152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0245563Medicaid
IAI18955Medicare PIN
IA0245563Medicaid