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Organization

FREDERICKSBURG FAMILY HEALTH CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH BERNARD PERAUD M.D. (DOCTOR)
(563) 237-5316
Entity
Organization

Contact information

Practice address
115 SCHULT RIDGE RD, FREDERICKSBURG, IA 50630-9582
(563) 237-5316
(563) 237-6337
Mailing address
115 SCHULT RIDGE RD, PO BOX 335, FREDERICKSBURG, IA 50630-9582
(563) 237-5316
(563) 237-6337

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0130401
IA
01
13040
BCBS
IA
01
16D0384603
CLIA#
IA
01
A004550
TRICARE PROV.#
IA
Enumeration date
06/02/2006
Last updated
01/23/2008
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