Organization
FAMILY PRACTICE CLINIC PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J MCCORMICK DO (OWNER PHYSICIAN)
(515) 989-3221
Entity
Organization
Contact information
Practice address
125 SCHOOL ST, CARLISLE, IA 50047-8702
(515) 989-3221
(515) 989-4518
Mailing address
125 SCHOOL ST, PO BOX F, CARLISLE, IA 50047-0705
(515) 989-3221
(515) 989-4518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0479345
—
IA
01
—
07022
WELLMARK
IA
01
—
124831
HEALTH PARTNERS
—
01
—
5656790001
DMERC REGION D
IA
01
—
DE5916
PALMETTO GBA RR MEDICARE
—
01
—
IA0100
HERITAGE
—
Enumeration date
09/19/2005
Last updated
07/31/2008
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