| Organization Name: | TRIMARK PHYSICIANS GROUP |
| NPI Number: | 1790161255 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL J DEWERFF (PRESIDENT) |
| Mailing Address: | 1303 11th Ave Manson |
| State: | IA US |
| Postal Code: | 505635065 |
| Phone Number: | 7124693307 |
| Fax Number: | 7124692614 |
| NPI Enumeration Date: | 08/07/2015 |
| NPI Last Update Date: | 08/07/2015 |
| 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: | |