Fmg-dupont Medical Clinic | |
1175 Center Dr #130 Dupont WA 98327-7733 | |
(253) 539-9735 | |
(253) 539-7981 |
Full Name | Fmg-dupont Medical Clinic |
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Speciality | Family Medicine |
Location | 1175 Center Dr, Dupont, Washington |
Authorized Official Name and Position | Cliff A. Robertson (CHIEF MEDICAL OFFICER) |
Authorized Official Contact | 2537796101 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Fmg-dupont Medical Clinic 1175 Center Dr #130 Dupont WA 98327-7733 Ph: (253) 964-5260 | Fmg-dupont Medical Clinic 1175 Center Dr #130 Dupont WA 98327-7733 Ph: (253) 539-9735 |
NPI Number | 1356486260 |
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Provider Enumeration Date | 02/20/2007 |
Last Update Date | 06/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356486260 | NPI | - | NPPES |
0217715 | Other | WA | STATE L&I |
7137136 | Medicaid | WA | |
7136674 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OP00002173 (Washington) | Primary |