Provider Demographics
NPI:1982692422
Name:DESCAMPS, RICKIE D (DO)
Entity type:Individual
Prefix:
First Name:RICKIE
Middle Name:D
Last Name:DESCAMPS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-1008
Mailing Address - Country:US
Mailing Address - Phone:641-828-7556
Mailing Address - Fax:
Practice Address - Street 1:1509 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-1008
Practice Address - Country:US
Practice Address - Phone:641-828-7556
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1858207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA01823Medicare UPIN