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Organization

AFFILIATES OF FAMILY PRACTICE OF CEDAR RAPIDS

Active
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Organization

AFFILIATES OF FAMILY PRACTICE OF CEDAR RAPIDS

Active
Other names
Affiliates of Family Practice
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH ALBERT CEARLOCK MD (PARTNER OWNER)
(319) 364-7730
Entity
Organization

Contact information

Practice address
1030 5TH AVENUE SE, SUITE 1700, CEDAR RAPIDS, IA 52403
(319) 364-7730
(319) 364-0240
Mailing address
1030 5TH AVENUE SE, SUITE 1700, CEDAR RAPIDS, IA 52403
(319) 364-7730
(319) 364-0240

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22198
IA
207Q00000X
Family Medicine Physician
34383
IA

Other

Enumeration date
08/21/2006
Last updated
08/22/2020
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