Healthcare Provider Details

I. General information

NPI: 1346356466
Provider Name (Legal Business Name): CLINTON URGENT CARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 S. 4TH ST
CLINTON IA
52732-4425
US

IV. Provider business mailing address

108 S. 4TH ST
CLINTON IA
52732-4425
US

V. Phone/Fax

Practice location:
  • Phone: 563-241-1239
  • Fax: 563-241-1243
Mailing address:
  • Phone: 563-241-1239
  • Fax: 563-241-1243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number31351
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number31351
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ODUAH DANIEL OSARO
Title or Position: PRESIDENT
Credential: MD
Phone: 563-241-1239