Basic Information
| Provider Information | |||||||||
| NPI: | 1174937163 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KADASI | ||||||||
| FirstName: | LAITH | ||||||||
| MiddleName: | MOHAMED | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193563185 | ||||||||
| FaxNumber: | 3193561520 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193563185 | ||||||||
| FaxNumber: | 3193561520 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2014 | ||||||||
| LastUpdateDate: | 07/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | LP03284 | RI | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0107X | MD-44979 | IA | N | 207WX0108X | MD-44979 | IA | N | 207W00000X | MD-44979 | IA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.