Organization
CHARITON VALLEY MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN S JEWETT MD (OWNER)
(641) 437-4344
Entity
Organization
Contact information
Practice address
707 S MAIN, CENTERVILLE, IA 52544-2421
(641) 437-4344
(641) 856-5410
Mailing address
PO BOX 100, 707 S MAIN, CENTERVILLE, IA 52544-2421
(641) 437-4344
(641) 856-5410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01603
IA
207Q00000X
Family Medicine Physician
17554
IA
207Q00000X
Family Medicine Physician
30574
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024141
—
IA
05
—
1110031
—
IA
05
—
3130443
—
IA
Enumeration date
04/06/2006
Last updated
08/22/2020
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