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5 N Federal Ave Ste 104 Mason City IA 50401-3270 | |
(641) 494-2404 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 5 N Federal Ave Ste 104, Mason City, Iowa |
Authorized Official Name and Position | Rebecca Jenkins (OWNER) |
Authorized Official Contact | 6414942404 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5 N Federal Ave Ste 104 Mason City IA 50401-3270 Ph: (641) 494-2404 | 5 N Federal Ave Ste 104 Mason City IA 50401-3270 Ph: (641) 494-2404 |
NPI Number | 1558403857 |
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Provider Enumeration Date | 02/13/2007 |
Last Update Date | 10/19/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558403857 | NPI | - | NPPES |
54422 | Other | IA | BLUE CROSS GROUP NUMBER |
0265223 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 02933 (Iowa) | Primary |
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