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NPI Code Detail

MEDICARE: TRIMARK PHYSICIANS GROUP INC

MEDICARE: TRIMARK PHYSICIANS GROUP INC
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
1261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1922084029
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRIMARK PHYSICIANS GROUP INC
Provider Business Mailing Address
First Line : 24 N 9TH ST
Second Line : SUITE A
City : FORT DODGE
State : IA
Zip : 50501-3905
Country : US
Telephone Number : 515-574-6890
Fax Number :
Provider Business Practice Location Address
First Line : 301 HIGHLAND AVE
Second Line :
City : SAC CITY
State : IA
Zip : 50583-2411
Country : US
Telephone Number : 712-662-7119
Fax Number :
Authorized Official
Title or Position : CFO
Name : MICHAEL J DEWERFF
Credential :
Telephone Number : 515-574-6603
Provider Enumeration Date : 12/20/2005
Last Update Date : 12/22/2010

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Directions to “TRIMARK PHYSICIANS GROUP INC ” Practice Location

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