Genesis Health System
Organization Active NPI Family Medicine Physician · Davenport, IA
NPI 1376654616 · NPPES record last updated Sep 29, 2009
Key facts
- NPI
- 1376654616
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- GENESIS HEALTH SYSTEM
- Practice address
- 210 W 53Rd St
Davenport, IA 52806-2251 - Phone
- (563) 386-3240
- Fax
- (563) 386-3211
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Mark G. Rogers
- Title
- Vice President of Finance
- Phone
- (563) 421-6513
Corporate family (same tax ID) 36
Practitioners 1
-
Conway Chin, DO
National Provider Directory
- Tax ID family
- Dav Med
Locations
210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
210 W 53Rd St
Davenport, IA 52806-2251
Mailing address
865 Lincoln Rd
Ste L10
Bettendorf, IA 52722-4190
Phone (563) 355-9191
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5727210012 | Other | DMERC |
Other names
- Genesis Health Group
Other providers in Davenport, IA
- Genesis Health System
- Genesis Health System
- Genesis Health System
- Genesis Health System
- Genesis Health System
- Genesis Health System
- Genesis Health System
- Genesis Health System
- Genesis Health System
- Genesis Health System
All providers in Davenport, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.