# FAMILY MEDICINE

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

## Provider details

- **NPI number:** 1134265341
- **Authorized official:** ANN FERGUSON (OFFICE MANAGER)
- **Authorized official phone:** (641) 236-6740

## Contact information

- **Practice address:** 224 3RD AVE, GRINNELL, IA 50112-1817
- **Practice address phone:** (641) 236-6740
- **Practice address fax:** (641) 236-0013
- **Mailing address:** 224 3RD AVE, GRINNELL, IA 50112-1817
- **Mailing address phone:** (641) 236-6740
- **Mailing address fax:** (641) 236-0013

## Taxonomy

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

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 08/22/2020