Healthcare Provider Details

I. General information

NPI: 1932155900
Provider Name (Legal Business Name): DANIEL ROBERT OLNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 NORTHGATE DR
IOWA CITY IA
52245-9565
US

IV. Provider business mailing address

2615 NORTHGATE DR
IOWA CITY IA
52245-9565
US

V. Phone/Fax

Practice location:
  • Phone: 319-351-5680
  • Fax: 319-351-8980
Mailing address:
  • Phone: 319-351-5680
  • Fax: 319-351-8980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number35918
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: