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NPI Code Detail

MEDICARE: CLINTON EMERGENCY ROOM ASSOCIATES

MEDICARE: CLINTON EMERGENCY ROOM ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3DC9207OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
238201OTHERWELLMARK BC/BS OF IOWA

General Provider Information

NPI Number : 1174584460
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINTON EMERGENCY ROOM ASSOCIATES
Provider Business Mailing Address
First Line : PO BOX 1894
Second Line :
City : MASON CITY
State : IA
Zip : 50402-1894
Country : US
Telephone Number : 641-494-3900
Fax Number :
Provider Business Practice Location Address
First Line : 1410 N 4TH ST
Second Line :
City : CLINTON
State : IA
Zip : 52732-2940
Country : US
Telephone Number : 563-244-5555
Fax Number :
Authorized Official
Title or Position : CEO
Name : DONNA OLIVER
Credential :
Telephone Number : 563-244-3530
Provider Enumeration Date : 03/28/2006
Last Update Date : 08/17/2018

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Directions to “CLINTON EMERGENCY ROOM ASSOCIATES ” Practice Location

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