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General NPI Number Information
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NPI Number | 1598735961
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSOCIATES OF MAQUOKETA PC
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 307 E WEBSTER ST
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City | WYOMING
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State | IA
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Zip | 52362
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Country | US
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Telephone | 563-488-2297
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Fax | 563-488-3313
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Provider Business Mailing Address
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Address Line | PO BOX 58 307 E WEBSTER ST
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City | WYOMING
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State | IA
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Zip | 52362-0058
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Country | US
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Telephone | 563-488-2297
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Fax | 563-488-3313
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | JENNIFER M ORR
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Credential |
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Telephone | 563-652-5145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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