Provider Demographics
NPI:1881475325
Name:ODEBOLT FAMILY HEALTH CENTER PLLC
Entity type:Organization
Organization Name:ODEBOLT FAMILY HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HOEFLING
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:712-830-3500
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:ODEBOLT
Mailing Address - State:IA
Mailing Address - Zip Code:51458-0432
Mailing Address - Country:US
Mailing Address - Phone:712-830-3500
Mailing Address - Fax:
Practice Address - Street 1:224 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ODEBOLT
Practice Address - State:IA
Practice Address - Zip Code:51458-7605
Practice Address - Country:US
Practice Address - Phone:712-830-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care