Organization
QUAD CITIES FAMILY FOOT AND ANKLE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW ROBERT WILBER DPM (OWNER)
(563) 324-2313
Entity
Organization
Contact information
Practice address
121 W LOCUST ST, #207, DAVENPORT, IA 52803-2827
(562) 324-2313
(562) 324-7483
Mailing address
121 W LOCUST ST, #207, DAVENPORT, IA 52803-2827
(562) 324-2313
(562) 324-7483
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
639
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440628
—
IA
01
—
54815
BLUE SHIELD
IA
Enumeration date
01/30/2008
Last updated
02/14/2008
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