Healthcare Provider Details

I. General information

NPI: 1922098482
Provider Name (Legal Business Name): JAMES R. MCQUEEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 SOUTH GRANT ROAD MCFARLAND CLINIC PC
CARROLL IA
51401-3047
US

IV. Provider business mailing address

1214 SOUTH GRANT ROAD MCFARLAND CLINIC PC
CARROLL IA
51401-3047
US

V. Phone/Fax

Practice location:
  • Phone: 712-792-1500
  • Fax: 712-792-7597
Mailing address:
  • Phone: 712-792-1500
  • Fax: 712-792-7597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01632
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: