Healthcare Provider Details

I. General information

NPI: 1346233541
Provider Name (Legal Business Name): SCOTT DONOHOE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S CRESCENT DR
MASON CITY IA
50401-2926
US

IV. Provider business mailing address

250 S CRESCENT DR
MASON CITY IA
50401-2926
US

V. Phone/Fax

Practice location:
  • Phone: 641-494-5340
  • Fax: 641-494-5294
Mailing address:
  • Phone: 641-494-5400
  • Fax: 641-494-5403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number789
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016005214
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2002014364
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: