Organization
GUTHRIE FAMILY MEDICINE CENTER PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN R BASCOM MD (PARTNER)
(641) 332-2365
Entity
Organization
Contact information
Practice address
502 MAIN, GUTHRIE CENTER, IA 50115
(641) 332-2365
(641) 332-2370
Mailing address
502 MAIN, GUTHRIE CENTER, IA 50115
(641) 332-2365
(641) 332-2370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0179945
—
IA
05
—
0183053
—
IA
05
—
0293423
—
IA
01
—
080023738
RR MEDICARE
—
01
—
080023739
RAIL ROAD MEDICARE
—
01
—
10821
MIDLANDS
—
01
—
17994
BLUE CROSS BLUE SHIELD
—
01
—
179945
FIRST ADMINISTRATORS
—
01
—
18305
BLUE CROSS BLUE SHIELD
—
01
—
183053
FIRST ADMINISTRATORS
—
01
—
22362
IOWA LICENCE NUMBER
—
01
—
22458
IOWA LICENCE NUMBER
—
01
—
241160
MIDLANDS
—
01
—
IA0105
JOHN DEERE
—
01
—
IA0106
JOHN DEERE
—
Enumeration date
03/09/2006
Last updated
12/23/2009
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