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General NPI Number Information
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NPI Number | 1730288556
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH PARTNERS OF THE QUAD CITIES, PC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3385 DEXTER CT SUITE 103
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City | DAVENPORT
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State | IA
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Zip | 52807-3471
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Country | US
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Telephone | 563-441-5860
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Fax | 563-441-5865
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Provider Business Mailing Address
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Address Line | 3385 DEXTER CT SUITE 103
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City | DAVENPORT
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State | IA
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Zip | 52807-3471
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Country | US
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Telephone | 563-441-5860
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Fax | 563-441-5865
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. JEFFREY S WALCZYK
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Credential | MD
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Telephone | 563-441-5860
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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 | 26742
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License Number State | IA
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