# VITAE FAMILY CARE CLINIC, L.L.C.

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

## Provider details

- **NPI number:** 1386909331
- **Authorized official:** DR. GREGORY CARTER MCKERNAN D.O. (PHYSICIAN/MANAGER/MEMBER)
- **Authorized official phone:** (641) 203-3548

## Contact information

- **Practice address:** 1355 50TH ST, SUITE 100, WEST DES MOINES, IA 50266-1617
- **Practice address phone:** (515) 225-3261
- **Practice address fax:** (515) 225-1944
- **Mailing address:** 1355 50TH ST, SUITE 100, WEST DES MOINES, IA 50266-1617
- **Mailing address phone:** (515) 225-3261
- **Mailing address fax:** (515) 225-1944

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02827 | IA | Yes |

## Other

- **Enumeration date:** 07/05/2012
- **Last updated:** 07/06/2012