Organization
MERCY PHYSICIAN ASSOCIATES
Active
Other names
Mercy Care Johnson Ave
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE J STANTON (SR DIRECTOR)
(319) 369-4512
Entity
Organization
Contact information
Practice address
75 SHORT ST NW, CEDAR RAPIDS, IA 52405-4203
(319) 369-4798
Mailing address
PO BOX 1824, CEDAR RAPIDS, IA 52406-1824
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0144832
—
IA
05
—
0792945
—
IA
Enumeration date
06/22/2007
Last updated
02/01/2011
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