# FAMILY MEDICINE CLINIC

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

## Provider details

- **NPI number:** 1992023642
- **Authorized official:** DR. DOUG J MIEDEMA DO (PARTNER)
- **Authorized official phone:** (712) 754-2900

## Contact information

- **Practice address:** 600 9TH AVE N, SIBLEY, IA 51249-1012
- **Practice address phone:** (712) 754-2900
- **Practice address fax:** (712) 754-2634
- **Mailing address:** PO BOX 277, SIBLEY, IA 51249-0277
- **Mailing address phone:** (712) 754-2900
- **Mailing address fax:** (712) 754-2634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 002069 | IA | Yes |

## Other

- **Enumeration date:** 05/05/2010
- **Last updated:** 05/05/2010