| Southern Iowa General Medicine Llc | |
|
105 E Mclane St Suite 400 Osceola IA 50213-1456 | |
| (641) 342-6337 | |
| (641) 342-6339 |
| Full Name | Southern Iowa General Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 105 E Mclane St, Osceola, Iowa |
| Authorized Official Name and Position | Carl Roleson (PRESIDENT CEO) |
| Authorized Official Contact | 5152373974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Iowa General Medicine Llc 2213 Grand Ave Des Moines IA 50312-5305 Ph: (515) 237-3974 | Southern Iowa General Medicine Llc 105 E Mclane St Suite 400 Osceola IA 50213-1456 Ph: (641) 342-6337 |
| NPI Number | 1043417637 |
|---|---|
| Provider Enumeration Date | 06/28/2007 |
| Last Update Date | 10/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043417637 | NPI | - | NPPES |
| 0400207 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02987 (Iowa) | Primary |
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