| Distaff Professionals, Llc | |
|
607 W Jefferson St Bloomfield IA 52537-1516 | |
| (641) 664-3621 | |
| (641) 664-3690 |
| Full Name | Distaff Professionals, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 607 W Jefferson St, Bloomfield, Iowa |
| Authorized Official Name and Position | Dorothy Cline-campbell (MANAGER) |
| Authorized Official Contact | 6416643621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Distaff Professionals, Llc Po Box 67 Bloomfield IA 52537-0067 Ph: (641) 664-3621 | Distaff Professionals, Llc 607 W Jefferson St Bloomfield IA 52537-1516 Ph: (641) 664-3621 |
| NPI Number | 1265480040 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 02/01/2010 |
| Medicare PECOS PAC ID | 1658363387 |
|---|---|
| Medicare Enrollment ID | O20040401000673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265480040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dorothy W Cline Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568411817 PECOS PAC ID: 5092707737 Enrollment ID: I20080223000056 |
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