Healthcare Provider Details

I. General information

NPI: 1962970004
Provider Name (Legal Business Name): MCFARLAND CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DUFF AVE
AMES IA
50010-5745
US

IV. Provider business mailing address

1215 DUFF AVE
AMES IA
50010-5469
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-4401
  • Fax: 515-239-4791
Mailing address:
  • Phone: 515-239-4401
  • Fax: 515-239-4791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: JEB ODEIN LEE
Title or Position: EXEC. DIR. CLINICAL OPERATIONS
Credential:
Phone: 515-239-4452