| Chautauqua Clinic | |
|
2709 W Briggs Ave Ste 4 Fairfield IA 52556-2649 | |
| (641) 472-7216 | |
| (641) 209-6690 |
| Full Name | Chautauqua Clinic |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2709 W Briggs Ave Ste 4, Fairfield, Iowa |
| Authorized Official Name and Position | Russell Duane England (MEDICAL DOCTOR PSYCHIATRY) |
| Authorized Official Contact | 6414727216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chautauqua Clinic 2709 W Briggs Ave Ste 4 Fairfield IA 52556-2649 Ph: (641) 472-7216 | Chautauqua Clinic 2709 W Briggs Ave Ste 4 Fairfield IA 52556-2649 Ph: (641) 472-7216 |
| NPI Number | 1841569936 |
|---|---|
| Provider Enumeration Date | 12/20/2011 |
| Last Update Date | 06/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841569936 | NPI | - | NPPES |
| 0056978 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 23126 (Iowa) | Primary |
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