Healthcare Provider Details

I. General information

NPI: 1184615130
Provider Name (Legal Business Name): ALAN KENT MUNSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 DUFF AVE
AMES IA
50010-3014
US

IV. Provider business mailing address

1015 DUFF AVE
AMES IA
50010-3014
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-4414
  • Fax: 515-239-4786
Mailing address:
  • Phone: 515-239-4414
  • Fax: 515-239-4786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number17768
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: