| Maquoketa Family Clinic | |
|
206 N Arcade St Maquoketa IA 52060-2022 | |
| (563) 652-6711 | |
| (563) 652-6715 |
| Full Name | Maquoketa Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 206 N Arcade St, Maquoketa, Iowa |
| Authorized Official Name and Position | Sarah Taylor (OFFICE MANAGER) |
| Authorized Official Contact | 5636526711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maquoketa Family Clinic 206 N Arcade St Maquoketa IA 52060-2022 Ph: (563) 652-6711 | Maquoketa Family Clinic 206 N Arcade St Maquoketa IA 52060-2022 Ph: (563) 652-6711 |
| NPI Number | 1407845175 |
|---|---|
| Provider Enumeration Date | 10/17/2005 |
| Last Update Date | 09/02/2022 |
| Medicare PECOS PAC ID | 1951291095 |
|---|---|
| Medicare Enrollment ID | O20040319001180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407845175 | NPI | - | NPPES |
| 1659360816 | Medicaid | IA | |
| 1750370011 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Elizabeth A Gudgel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710211594 PECOS PAC ID: 7618015165 Enrollment ID: I20091104000059 |
| Provider Name | Ann E Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053544585 PECOS PAC ID: 6204951775 Enrollment ID: I20100921000839 |
| Provider Name | Jerald W Bybee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659360816 PECOS PAC ID: 4082708714 Enrollment ID: I20100921001062 |
| Provider Name | Roger R Waller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750370011 PECOS PAC ID: 5991899627 Enrollment ID: I20100921001096 |
| Provider Name | Vicki M Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124560206 PECOS PAC ID: 8628357670 Enrollment ID: I20161114002194 |
| Provider Name | Bradley B Waller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609433796 PECOS PAC ID: 0143555615 Enrollment ID: I20210305001903 |
Medical Associates Of Maquoketa, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 918 W Platt St # 1, Maquoketa, IA 52060 Phone: 563-652-5145 Fax: 563-652-3674 |