| Mercy Indianola Detroit Medical Clinic | |
|
112 E Detroit Ave Indianola IA 50125-1860 | |
| (515) 961-5324 | |
| (515) 961-0116 |
| Full Name | Mercy Indianola Detroit Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 112 E Detroit Ave, Indianola, Iowa |
| Authorized Official Name and Position | David Swieskowski (VICE PRESIDENT) |
| Authorized Official Contact | 5156437150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Indianola Detroit Medical Clinic Po Box 1475 Des Moines IA 50305-1475 Ph: (515) 643-4374 | Mercy Indianola Detroit Medical Clinic 112 E Detroit Ave Indianola IA 50125-1860 Ph: (515) 961-5324 |
| NPI Number | 1265458723 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 07/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265458723 | NPI | - | NPPES |
| 3207084 | Medicaid | IA | |
| CD3776 | Other | IA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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