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605 Washington St Fayette IA 52142-9206 | |
(563) 382-2911 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 605 Washington St, Fayette, Iowa |
Authorized Official Name and Position | Steven Robert Slessor (CAO) |
Authorized Official Contact | 5633873145 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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901 Montgomery St Decorah IA 52101-2325 Ph: (563) 382-2911 | 605 Washington St Fayette IA 52142-9206 Ph: (563) 382-2911 |
NPI Number | 1245857515 |
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Provider Enumeration Date | 07/02/2020 |
Last Update Date | 06/29/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245857515 | NPI | - | NPPES |
2908209 | Medicaid | IA | |
3908209 | Medicaid | IA | |
0908209 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |