| Preferred Image | |
|
460 N State Rd Lake View IA 51450-7307 | |
| (712) 830-3170 | |
| Not Available |
| Full Name | Preferred Image |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 460 N State Rd, Lake View, Iowa |
| Authorized Official Name and Position | Mark Mogensen (PROVIDER) |
| Authorized Official Contact | 7128304840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Image 460 N State Rd Lake View IA 51450-7307 Ph: (712) 830-3170 | Preferred Image 460 N State Rd Lake View IA 51450-7307 Ph: (712) 830-3170 |
| NPI Number | 1679430110 |
|---|---|
| Provider Enumeration Date | 01/07/2026 |
| Last Update Date | 01/07/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679430110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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