# FAMILY MEDICINE CLINIC, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063418820
- **Authorized official:** PAUL EDWARD DUDLEY I M.D. (PRESIDENT)
- **Authorized official phone:** (712) 423-1525

## Contact information

- **Practice address:** 1614 DIAMOND STREET PL, ONAWA, IA 51040-1554
- **Practice address phone:** (712) 423-1525
- **Practice address fax:** (712) 423-2528
- **Mailing address:** 1614 DIAMOND STREET PL, ONAWA, IA 51040-1554
- **Mailing address phone:** (712) 423-1525
- **Mailing address fax:** (712) 423-2528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | IA | Yes |

## Other

- **Enumeration date:** 06/24/2005
- **Last updated:** 07/21/2022