Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 04746 | IA |
N | 111NN0400X | Neurology | 124 | IA |
N | 111NS0005X | Chiropractic Sports Physician | 3036 | IA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 2388 | IA |
NPI | 1285694521 |
---|---|
Provider Name | Dr. Gregory A Mcdonald |
First Address | Iowa City, IA 52240-4742 |
Second Address | Iowa City, IA 52240-4742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 03/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1185496 | (05) | IA |
18549 | WELLMARK BCBS (01) | IA |
8103 | MIDLAND'S CHOICE ID (01) | IA |
T01066 | (02) | IA |