Provider Demographics
NPI:1285742478
Name:CLAYTON A FRANCIS MD
Entity type:Organization
Organization Name:CLAYTON A FRANCIS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:641-236-2500
Mailing Address - Street 1:P O BOX 780
Mailing Address - Street 2:210 4TH AVE
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-0780
Mailing Address - Country:US
Mailing Address - Phone:641-236-2500
Mailing Address - Fax:641-236-2539
Practice Address - Street 1:210 4TH AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-0780
Practice Address - Country:US
Practice Address - Phone:641-236-2500
Practice Address - Fax:641-236-2539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0294801Medicaid
IA2112698Medicaid
IA0294801Medicaid
I10271Medicare PIN
IAE53315Medicare UPIN