Organization Name: | COLFAX MEDICAL ASSOCIATES |
NPI Number: | 1750752333 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREG INGLE (MEDICAL DIRECTOR) |
Mailing Address: | 107 N Walnut St Colfax |
State: | IA US |
Postal Code: | 500541039 |
Phone Number: | 5152500664 |
Fax Number: | |
NPI Enumeration Date: | 10/08/2015 |
NPI Last Update Date: | 10/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | A115413 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |