Organization
BURGESS HEALTH CENTER
Active
Parent organization
BURGESS HEALTH CENTER
Other names
Burgess Family Clinic - Sloan
Organization subpart
Yes
Provider details
NPI number
Legal business name
BURGESS HEALTH CENTER
Authorized official
LYNN R WOLD (CEO)
(712) 423-2311
Entity
Organization
Contact information
Practice address
409 EVANS ST, SLOAN, IA 51055-7748
(712) 428-4100
(712) 428-4102
Mailing address
1600 DIAMOND ST, ONAWA, IA 51040-1548
(712) 423-2311
(712) 423-9199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
IA
208D00000X
General Practice Physician
—
IA
261QR1300X
Rural Health Clinic/Center
Primary
—
IA
363L00000X
Nurse Practitioner
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0634865
—
IA
Enumeration date
11/02/2009
Last updated
07/09/2024
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