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Organization
CRESTON MEDICAL CLINIC, P.C.
Active
Organization
CRESTON MEDICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES E MANSOUR M.D. (PRESIDENT OF THE CORPORATION)
(641) 782-2131
Entity
Organization
Contact information
Practice address
1610 W TOWNLINE ST, SUITE 200, CRESTON, IA 50801-1066
(641) 782-2131
(641) 782-6425
Mailing address
1610 W TOWNLINE ST, SUITE 200, CRESTON, IA 50801-1066
(641) 782-2131
(641) 782-6425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
05/17/2006
Last updated
10/02/2007
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