Provider Demographics
NPI:1043912330
Name:NORTH CENTRAL OCCUPATIONAL MEDICINE & WALK IN CLINIC,PLLC
Entity Type:Organization
Organization Name:NORTH CENTRAL OCCUPATIONAL MEDICINE & WALK IN CLINIC,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN FLAHERTY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:712-358-3054
Mailing Address - Street 1:30 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4331
Mailing Address - Country:US
Mailing Address - Phone:713-358-3054
Mailing Address - Fax:
Practice Address - Street 1:30 N 27TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4331
Practice Address - Country:US
Practice Address - Phone:713-358-3054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center