Provider Demographics
NPI:1275373938
Name:HADEN FAMILY MEDICINE PC
Entity type:Organization
Organization Name:HADEN FAMILY MEDICINE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FAMILY MEDICINE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:HADEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:641-552-1484
Mailing Address - Street 1:1111 N HAYNES AVE
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-1133
Mailing Address - Country:US
Mailing Address - Phone:415-521-4846
Mailing Address - Fax:641-328-8729
Practice Address - Street 1:1111 N HAYNES AVE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-1133
Practice Address - Country:US
Practice Address - Phone:515-408-5105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty