Provider Demographics
NPI:1609869700
Name:INFINITY MEDICAL CLINIC PC
Entity Type:Organization
Organization Name:INFINITY MEDICAL CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARAE
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:STEMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:319-826-6374
Mailing Address - Street 1:521 E MOUNT PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1462
Mailing Address - Country:US
Mailing Address - Phone:319-754-1777
Mailing Address - Fax:319-754-1999
Practice Address - Street 1:905 29TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-1138
Practice Address - Country:US
Practice Address - Phone:319-826-6374
Practice Address - Fax:319-826-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty