Healthcare Provider Details

I. General information

NPI: 1922069681
Provider Name (Legal Business Name): DOUGLAS G MCLAWS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 06/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 6TH STREET
MANNING IA
51455-1004
US

IV. Provider business mailing address

1550 6TH ST
MANNING IA
51455-1005
US

V. Phone/Fax

Practice location:
  • Phone: 712-655-2072
  • Fax: 712-655-3228
Mailing address:
  • Phone: 712-655-2072
  • Fax: 712-655-3228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3267
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: