Healthcare Provider Details

I. General information

NPI: 1851348775
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF CLINTON, IOWA, P.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 E LINCOLNWAY
MORRISON IL
61270-2509
US

IV. Provider business mailing address

915 13TH AVE N
CLINTON IA
52732-5067
US

V. Phone/Fax

Practice location:
  • Phone: 815-772-7491
  • Fax: 815-772-7891
Mailing address:
  • Phone: 563-243-2511
  • Fax: 563-243-0817

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: THOMAS A MOSER
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 563-243-2511