| Organization Name: | TRIMARK PHYSICIANS GROUP |
| NPI Number: | 1033527114 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL J DEWERFF (CFO) |
| Mailing Address: | 804 Kenyon Rd Ste D Fort Dodge |
| State: | IA US |
| Postal Code: | 505015744 |
| Phone Number: | 5155746855 |
| Fax Number: | 5155737274 |
| NPI Enumeration Date: | 08/01/2014 |
| NPI Last Update Date: | 02/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |