Healthcare Provider Details

I. General information

NPI: 1285694521
Provider Name (Legal Business Name): GREGORY A MCDONALD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

943 S GILBERT ST SUITE 1
IOWA CITY IA
52240-4742
US

IV. Provider business mailing address

943 S GILBERT ST SUITE 1
IOWA CITY IA
52240-4742
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-2273
  • Fax: 319-338-1225
Mailing address:
  • Phone: 319-338-2273
  • Fax: 319-338-1225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number04746
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number124
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number3036
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number2388
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: