Organization
MERCY PHYSICIAN ASSOCIATES, INC
Active
Parent organization
MERCY PHYSICIAN ASSOCIATES, INC
Other names
Merycare Prarie Creek
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY PHYSICIAN ASSOCIATES, INC
Authorized official
MR. TIMOTHY L CHARLES (PRESIDENT CEO)
(319) 398-6697
Entity
Organization
Contact information
Practice address
777 76TH AVENUE DR SW, CEDAR RAPIDS, IA 52404-7006
(319) 558-0350
(319) 558-0351
Mailing address
PO BOX 1824, CEDAR RAPIDS, IA 52406-1824
(319) 558-0350
(319) 558-0351
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
08/18/2016
Last updated
07/25/2019
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