Healthcare Provider Details

I. General information

NPI: 1285742478
Provider Name (Legal Business Name): CLAYTON A FRANCIS MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 4TH AVE
GRINNELL IA
50112-0780
US

IV. Provider business mailing address

P O BOX 780 210 4TH AVE
GRINNELL IA
50112-0780
US

V. Phone/Fax

Practice location:
  • Phone: 641-236-2500
  • Fax: 641-236-2539
Mailing address:
  • Phone: 641-236-2500
  • Fax: 641-236-2539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number30077
License Number StateIA

VIII. Authorized Official

Name: DR. CLAYTON A FRANCIS
Title or Position: OWNER/PROVIDER
Credential: MD
Phone: 641-236-2500