PROACTIVE MD IA PC; NPI #1922777465

Contact Information

PROACTIVE MD IA PC

1182 260TH ST
SERGEANT BLUFF, IA 51054-7739

Phone: 712-317-1130
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for PROACTIVE MD IA PC

NPI #	`1922777465`
LBN Legal business name	PROACTIVE MD IA PC
Authorized official	MARK KEMBLE - (CMO)
Entity	Organization
Organization subpart ¹	No
Enumeration date	09/08/2021
Last updated	04/10/2025 - More than a year ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PROACTIVE MD IA PC

Contact Information

Specialty

Primary Care

NPI Profile & details for PROACTIVE MD IA PC

Reviews for PROACTIVE MD IA PC