Healthcare Provider Details

I. General information

NPI: 1265430961
Provider Name (Legal Business Name): QUAD CITY FAMILY PHYSICIANS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 N MARQUETTE ST
DAVENPORT IA
52806-4430
US

IV. Provider business mailing address

3940 N MARQUETTE ST
DAVENPORT IA
52806-4430
US

V. Phone/Fax

Practice location:
  • Phone: 563-386-3111
  • Fax:
Mailing address:
  • Phone: 563-386-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateIA

VIII. Authorized Official

Name: ELIZABETH ESTILOW
Title or Position: OFFICE MANAGER
Credential:
Phone: 877-479-6525