Family Medicine Clinic

Organization Active NPI Family Medicine Physician · Sibley, IA

NPI 1124026489 · NPPES record last updated Jul 23, 2009

Key facts

NPI
1124026489
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
18374 (IA)
Legal business name
FAMILY MEDICINE CLINIC
Practice address
600 9TH Ave N
Sibley, IA 51249-1012
Phone
(712) 754-3658
Fax
(712) 754-2634
NPI assigned
Jul 11, 2005
Organization subpart
No

Authorized official

Name
Dr. William Earl Hicks, M.D.
Title
Partner
Phone
(712) 754-3658

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 18374 IA Yes
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 18381 IA
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 02364 IA
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 02096 IA
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 3511 IA
Geriatric Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QG0300X 18374 IA
Sports Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QS0010X 18374 IA

Addresses

Primary practice location

600 9TH Ave N
Sibley, IA 51249-1012

Mailing address

600 9TH Ave N
PO Box 277
Sibley, IA 51249-1012
Phone (712) 754-3658

Other identifiers

IdentifierTypeStateIssuer
0087106MedicaidIA
626810200MedicaidMN
115341OtherMNMINNESOTA UCARE

Other providers in Sibley, IA

All providers in Sibley, IA · Family Medicine Physician in Iowa

Sources for this page

Verify at the official NPI Registry.