| Iowa Physicians Clinic Medical Foundation | |
|
411 1st Ave Clarence IA 52216-9744 | |
| (563) 452-3211 | |
| (563) 452-3215 |
| Full Name | Iowa Physicians Clinic Medical Foundation |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 411 1st Ave, Clarence, Iowa |
| Authorized Official Name and Position | Erick J Laine (COO) |
| Authorized Official Contact | 5154719227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iowa Physicians Clinic Medical Foundation 8101 Birchwood Court Suite R Johnston IA 50131-2930 Ph: (515) 471-9243 | Iowa Physicians Clinic Medical Foundation 411 1st Ave Clarence IA 52216-9744 Ph: (563) 452-3211 |
| NPI Number | 1194760561 |
|---|---|
| Provider Enumeration Date | 06/18/2006 |
| Last Update Date | 08/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194760561 | NPI | - | NPPES |
| 0638981 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
St Luke's Jones Regional Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 411 1st Ave, Clarence, IA 52216 Phone: 563-452-3211 Fax: 563-452-3215 |