| Organization Name: | BOONE COUNTY FAMILY MEDICINE TR |
| NPI Number: | 1033154836 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH S SMITH (CEO) |
| Mailing Address: | 1115 S Marshall St Boone |
| State: | IA US |
| Postal Code: | 500365304 |
| Phone Number: | 5154322335 |
| Fax Number: | 5154322357 |
| NPI Enumeration Date: | 06/17/2006 |
| NPI Last Update Date: | 01/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |