Quad Cities Primary Care, Llc | |
3385 Dexter Ct Ste 105 Davenport IA 52807-3471 | |
(563) 940-6604 | |
Not Available |
Full Name | Quad Cities Primary Care, Llc |
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Speciality | Family Medicine |
Location | 3385 Dexter Ct Ste 105, Davenport, Iowa |
Authorized Official Name and Position | Katy Hegg (OFFICE MANAGER) |
Authorized Official Contact | 5635513800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Quad Cities Primary Care, Llc 3385 Dexter Ct Ste 105 Davenport IA 52807-3471 Ph: (563) 551-3800 | Quad Cities Primary Care, Llc 3385 Dexter Ct Ste 105 Davenport IA 52807-3471 Ph: (563) 940-6604 |
NPI Number | 1588332977 |
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Provider Enumeration Date | 09/01/2021 |
Last Update Date | 11/18/2021 |
Medicare PECOS PAC ID | 2961800933 |
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Medicare Enrollment ID | O20211005001753 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588332977 | NPI | - | NPPES |
1255310744 | Other | IA | NPI |
1821077322 | Other | IA | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | Lisa Ann Kopp |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821077322 PECOS PAC ID: 0345213740 Enrollment ID: I20050207000378 |
Provider Name | Candyce L Ackland |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1255310744 PECOS PAC ID: 9537110630 Enrollment ID: I20050207000388 |
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