Provider Demographics
NPI:1851348775
Name:MEDICAL ASSOCIATES OF CLINTON, IOWA, P.L.C.
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF CLINTON, IOWA, P.L.C.
Other - Org Name:MORRISON FAMILY HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-243-2511
Mailing Address - Street 1:915 13TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-5067
Mailing Address - Country:US
Mailing Address - Phone:563-243-2511
Mailing Address - Fax:563-243-0817
Practice Address - Street 1:635 E LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:IL
Practice Address - Zip Code:61270-2509
Practice Address - Country:US
Practice Address - Phone:815-772-7491
Practice Address - Fax:815-772-7891
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL ASSOCIATES OF CLINTON IOWA PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-27
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL778840Medicare ID - Type Unspecified