Genesis Health System
Family Medicine in Davenport, IA. Organization (NPI-2).
NPI number1124454947
StatusActive
Last updated in NPPESSep 25, 2013
Details
- NPI
- 1124454947
- Entity type
- Organization (NPI-2)
- Legal business name
- Genesis Health System
- Organization subpart
- No
- Enumeration date
- Sep 25, 2013
- Last updated
- Sep 25, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Genesis Health Group Davenport Clinic Health Home (Doing Business As)
Practice location
1820 W 3rd StDavenport, IA 52802-1812
Phone 563-421-0500 · Fax 563-326-1901
Mailing address
865 Lincoln RdSuite L10
Bettendorf, IA 52722-4190
Phone 563-355-9200 · Fax 563-355-3419
Authorized official
Mark G. Rogers
Vp Of Finance
5634216513
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