Organization
FAMILY PHYSICIANS OF CEDAR RAPIDS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J GOEDKEN MD (PRESIDENT)
(319) 365-7581
Entity
Organization
Contact information
Practice address
1515 42ND ST NE, CEDAR RAPIDS, IA 52402-3061
(319) 365-7581
(319) 365-0163
Mailing address
1515 42ND ST NE, CEDAR RAPIDS, IA 52402-3061
(319) 365-7581
(319) 365-0163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0154682
—
IA
01
—
15468
CLINIC NUMBER
IA
Enumeration date
07/03/2006
Last updated
06/23/2022
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