Provider Demographics
NPI:1356831531
Name:IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Other - Org Name:UNITYPOINT CLINIC - FAMILY MEDICINE - WILTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-471-9227
Mailing Address - Street 1:PO BOX 4827
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-4827
Mailing Address - Country:US
Mailing Address - Phone:515-471-9300
Mailing Address - Fax:515-471-9320
Practice Address - Street 1:400 OVESEN DR
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:IA
Practice Address - Zip Code:52778
Practice Address - Country:US
Practice Address - Phone:563-732-2121
Practice Address - Fax:563-732-4232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health