Provider Demographics
NPI:1922314533
Name:ADVANCED FAMILY MEDICINE PC
Entity Type:Organization
Organization Name:ADVANCED FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOODHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-832-7928
Mailing Address - Street 1:903 WILLSON AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50595-2214
Mailing Address - Country:US
Mailing Address - Phone:515-832-3332
Mailing Address - Fax:515-832-1114
Practice Address - Street 1:903 WILLSON AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-2214
Practice Address - Country:US
Practice Address - Phone:515-832-3332
Practice Address - Fax:515-832-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care