Organization
SIOUXLAND MEDICAL EDUCATION FOUNDATION, INC
Active
Other names
Family Practice Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WERNER (OFFICE MANAGER)
(712) 294-5000
Entity
Organization
Contact information
Practice address
2501 PIERCE ST, SIOUX CITY, IA 51104-3725
(712) 294-5000
(712) 294-5091
Mailing address
2501 PIERCE ST, SIOUX CITY, IA 51104-3725
(712) 294-5000
(712) 294-5091
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0146191
—
IA
01
—
14619
MEDICARE GROUP
IA
Enumeration date
01/04/2006
Last updated
09/26/2007
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