# FAMILY PRACTICE CENTER

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

## Provider details

- **NPI number:** 1518946953
- **Authorized official:** PHILIP PETERSON (SR. VICE PRESIDENT/CFO FINANCE)
- **Authorized official phone:** (319) 398-6793

## Contact information

- **Practice address:** 610 8TH ST SE, CEDAR RAPIDS, IA 52401-2143
- **Practice address phone:** (319) 398-6170
- **Practice address fax:** (319) 398-6466
- **Mailing address:** 610 8TH ST SE, CEDAR RAPIDS, IA 52401-2143
- **Mailing address phone:** (319) 398-6170
- **Mailing address fax:** (319) 398-6466

## Taxonomy

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

## Other

- **Enumeration date:** 01/13/2006
- **Last updated:** 08/12/2008