Provider Demographics
NPI:1851839153
Name:IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Other - Org Name:UNITYPOINT CLINIC-FAMILY MEDICINE-SHELLSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position: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:MD
Authorized Official - Phone:515-241-3280
Mailing Address - Street 1:131 MAIN STREET NW
Mailing Address - Street 2:
Mailing Address - City:SHELLSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:52332-9554
Mailing Address - Country:US
Mailing Address - Phone:319-436-2040
Mailing Address - Fax:319-436-2027
Practice Address - Street 1:131 MAIN STREET NW
Practice Address - Street 2:
Practice Address - City:SHELLSBURG
Practice Address - State:IA
Practice Address - Zip Code:52332-9554
Practice Address - Country:US
Practice Address - Phone:319-436-2040
Practice Address - Fax:319-436-2027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty