Healthcare Provider Details

I. General information

NPI: 1013904523
Provider Name (Legal Business Name): MEDICAL ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 09/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 6TH AVE NE
LE MARS IA
51031-3716
US

IV. Provider business mailing address

194 6TH AVE NE
LE MARS IA
51031-3716
US

V. Phone/Fax

Practice location:
  • Phone: 712-546-3604
  • Fax: 712-546-9307
Mailing address:
  • Phone: 712-546-3604
  • Fax: 712-546-9307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIE ANN SITZMANN
Title or Position: OFFICE MANAGER
Credential:
Phone: 712-546-3604