WATERFORD FAMILY MEDICINE PC NPI 1942470828

NPI Information

WATERFORD FAMILY MEDICINE PC is a family medicine in Davenport, IA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WATERFORD FAMILY MEDICINE PC NPI is 1942470828. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1820 E 54TH ST
STE B
DAVENPORT, IA
ZIP 52807-797
Phone: (563) 355-9990
Fax: (563) 355-9999

The provider's authorized official is Tammy J Wells .
The authorized official title is Owner and has the following contact phone number (563) 355-9990.

The CLIA number assigned to this NPI record is 16D0963126 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/6/2008 and was last updated on 3/6/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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