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5409 Avenue O Fort Madison IA 52627-9601 | |
(319) 376-2134 | |
(319) 376-2188 |
Full Name | |
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Speciality | Family Medicine |
Location | 5409 Avenue O, Fort Madison, Iowa |
Authorized Official Name and Position | Shelby L Burchett (CEO) |
Authorized Official Contact | 3193762124 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1470 Fort Madison IA 52627-1470 Ph: (319) 376-2134 | 5409 Avenue O Fort Madison IA 52627-9601 Ph: (319) 376-2134 |
NPI Number | 1629024286 |
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Provider Enumeration Date | 05/25/2006 |
Last Update Date | 05/11/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629024286 | NPI | - | NPPES |
0122978 | Medicaid | IA | |
51179 | Other | IA | BLUE CROSS BLUE SHIELD |
Qv Urgent Care Ia Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1501 39th St, Fort Madison, IA 52627 Phone: 319-774-7518 | |