| Medical Clinic P.c. | |
|
313 Main St Sidney IA 51652 | |
| (712) 374-2649 | |
| (712) 374-2467 |
| Full Name | Medical Clinic P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 313 Main St, Sidney, Iowa |
| Authorized Official Name and Position | Thomas Homer Largen (OWNER/PRESIDENT) |
| Authorized Official Contact | 7123822626 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Clinic P.c. 1219 Main St Hamburg IA 51640-1300 Ph: (712) 382-2626 | Medical Clinic P.c. 313 Main St Sidney IA 51652 Ph: (712) 374-2649 |
| NPI Number | 1871566265 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5395634216 |
|---|---|
| Medicare Enrollment ID | O20101008000771 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871566265 | NPI | - | NPPES |
| 13046 | Other | IA | WELLMARK BC/BS OF IA |
| 0638338 | Medicaid | IA | |
| 0018507 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Shenandoah Physicians Clinic-sidney Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 802 Illinois St, Sidney, IA 51652 Phone: 712-374-6005 Fax: 712-374-3100 | |
Shenandoah Physicians Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 802 Illinois St, Sidney, IA 51652 Phone: 712-374-6005 Fax: 712-374-2301 |