| Midwest Spine Center | |
|
705 N 15th St Fort Dodge IA 50501-3344 | |
| (515) 576-1176 | |
| (515) 573-5295 |
| Full Name | Midwest Spine Center |
|---|---|
| Speciality | Clinic/center |
| Location | 705 N 15th St, Fort Dodge, Iowa |
| Authorized Official Name and Position | Ben Rogers (OWNER) |
| Authorized Official Contact | 5155761176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Spine Center 705 N 15th St Fort Dodge IA 50501-3344 Ph: (515) 576-1176 | Midwest Spine Center 705 N 15th St Fort Dodge IA 50501-3344 Ph: (515) 576-1176 |
| NPI Number | 1750412318 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 07/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750412318 | NPI | - | NPPES |
| 0425488 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | AO5814 (Iowa) | Primary |
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