Waterford Family Medicine Pc

LBN: Waterford Family Medicine Pc
Waterford Family Medicine Pc is an health care organization with primary practice located at 1820 E 54Th St Ste B, Davenport IA 52807-2797. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Waterford Family Medicine Pc can be contacted via phone (563) 355-9990, or through Wells, Tammy J via phone (563) 355-9990.

Contact Information

Primary practice address
1820 E 54Th St Ste B Davenport IA 52807-2797
Phone: (563) 355-9990
Fax: (563) 355-9999
Website:
Map and Directions
Authorized official contact:
Name: Wells, Tammy J Doctor of Medicine (MD)
Phone: (563) 355-9990

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1093794968 Iowa

Profile Details

NPI number 1942470828
LBN Legal business name Waterford Family Medicine Pc
DBA Doing business as
Authorized official Wells, Tammy J Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 6th, 2008
Last updated Mar 6th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942470828 NPPES
Iowa Other 49490 BLUE SHIELD
Iowa MEDICAID 7100883 BLUE SHIELD

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