MEDICARE: DALLAS CENTER MEDICAL ASSOCIATES PC

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
1	207Q00000X	Family Medicine Physician	01933	IA

General Provider Information

NPI Number	:	1225209042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS CENTER MEDICAL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	507 14TH ST
Second Line	:
City	:	DALLAS CENTER
State	:	IA
Zip	:	50063-7738
Country	:	US
Telephone Number	:	515-992-3711
Fax Number	:	515-992-3803

Provider Business Practice Location Address
First Line	:	507 14TH ST
Second Line	:
City	:	DALLAS CENTER
State	:	IA
Zip	:	50063-7738
Country	:	US
Telephone Number	:	515-992-3711
Fax Number	:	515-992-3803

Authorized Official
Title or Position	:	OWNER
Name	:	RONALD RAY MCHOSE
Credential	:	D.O.
Telephone Number	:	515-992-3711

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	03/19/2008

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