Provider Demographics
NPI:1285732537
Name:FAMILY & SPECIALTY MEDICAL CENTER, P.C.
Entity type:Organization
Organization Name:FAMILY & SPECIALTY MEDICAL CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-792-4000
Mailing Address - Street 1:2540 N AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-7584
Mailing Address - Country:US
Mailing Address - Phone:712-263-4545
Mailing Address - Fax:712-263-8275
Practice Address - Street 1:2540 N AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-7584
Practice Address - Country:US
Practice Address - Phone:712-263-4545
Practice Address - Fax:712-263-8275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA71934Medicare ID - Type UnspecifiedMEDICARE GROUP #