Individual
TERRY L SPRAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
222 BROADWAY, AUDUBON MEDICAL CLINIC, AUDUBON, IA 50025
(712) 563-4206
(712) 563-2001
Mailing address
222 BROADWAY, AUDUBON MEDICAL CLINIC, AUDUBON, IA 50025
(712) 563-4206
(712) 563-2001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01713
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0152082
MEDICAID HOSPITAL
IA
05
—
0638536
—
IA
01
—
15208
WELLMARK
IA
01
—
I3937
MEDICARE B
IA
Enumeration date
05/03/2006
Last updated
01/18/2008
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