MEDICARE: DR. DAVID L KEARNS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	00752	IA

General Provider Information

NPI Number	:	1447246020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID L KEARNS PHD

Provider Business Mailing Address
First Line	:	511 IOWA AVE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-1833
Country	:	US
Telephone Number	:	319-354-8906
Fax Number	:

Provider Business Practice Location Address
First Line	:	511 IOWA AVE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-1833
Country	:	US
Telephone Number	:	319-354-8906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	10/13/2014

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