Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI WALZ (PROGRAM ASSISTANT)
(563) 421-4400
Entity
Organization
Contact information
Practice address
1345 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1844
(563) 421-4400
(563) 421-4449
Mailing address
1345 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1844
(563) 421-4400
(563) 421-4449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0495747
—
IA
05
—
0495952
—
IA
Enumeration date
07/28/2006
Last updated
08/22/2020
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