| Centerville Medical Clinic | |
|
19876 St. Joseph Drive Centerville IA 52544 | |
| (641) 856-8684 | |
| Not Available |
| Full Name | Centerville Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 19876 St. Joseph Drive, Centerville, Iowa |
| Authorized Official Name and Position | Kenneth L Fisher (CFO) |
| Authorized Official Contact | 3193842844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerville Medical Clinic 2941 Sierra Ct Sw Iowa City IA 52240-8503 Ph: (319) 337-7642 | Centerville Medical Clinic 19876 St. Joseph Drive Centerville IA 52544 Ph: (641) 856-8684 |
| NPI Number | 1700835865 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 07/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700835865 | NPI | - | NPPES |
| DA0044 | Other | IA | RR MEDICARE |
| 0280339 | Medicaid | IA | |
| 33226 | Other | IA | WELLMARK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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