MEDICARE: DR. JOHN MARKUS DELEEUW DO

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	207R00000X	Internal Medicine Physician	2006018696	MO
2	208M00000X	Hospitalist Physician	2006018696	MO
3	208M00000X	Hospitalist Physician	DO-06088	IA
4	207R00000X	Internal Medicine Physician	DO-06088	IA

General Provider Information

NPI Number	:	1770590846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MARKUS DELEEUW DO

Provider Business Mailing Address
First Line	:	1607 S BALTIMORE ST
Second Line	:
City	:	KIRKSVILLE
State	:	MO
Zip	:	63501-4536
Country	:	US
Telephone Number	:	660-627-3363
Fax Number	:	660-627-3367

Provider Business Practice Location Address
First Line	:	1607 S BALTIMORE ST
Second Line	:
City	:	KIRKSVILLE
State	:	MO
Zip	:	63501-4536
Country	:	US
Telephone Number	:	660-627-3363
Fax Number	:	660-627-3367

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	01/23/2025

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