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1301 W Main St Lake City IA 51449-1585 | |
(712) 464-3171 | |
(712) 464-3269 |
Full Name | |
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Speciality | Family Medicine |
Location | 1301 W Main St, Lake City, Iowa |
Authorized Official Name and Position | James L Henkenius (CFO) |
Authorized Official Contact | 7124644200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1301 W Main St Lake City IA 51449-1585 Ph: (712) 464-3171 | 1301 W Main St Lake City IA 51449-1585 Ph: (712) 464-3171 |
NPI Number | 1013058924 |
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Provider Enumeration Date | 02/12/2007 |
Last Update Date | 08/05/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013058924 | NPI | - | NPPES |
0007880 | Medicaid | IA |