Healthcare Provider Details

I. General information

NPI: 1457300790
Provider Name (Legal Business Name): MEDICAL ASSOCIATES CLINIC P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 ASSOCIATES DR
DUBUQUE IA
52002-2201
US

IV. Provider business mailing address

1500 ASSOCIATES DR
DUBUQUE IA
52002-2201
US

V. Phone/Fax

Practice location:
  • Phone: 563-584-4100
  • Fax: 563-584-4110
Mailing address:
  • Phone: 563-584-4100
  • Fax: 563-584-4110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ZACHARY C KEELING
Title or Position: C.E.O.
Credential:
Phone: 563-584-4100