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NPI Code Detail

MEDICARE: DR. CHARLES D. MOONEY MD

MEDICARE: DR. CHARLES D. MOONEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083X0100XOccupational Medicine Physician34101IA

General Provider Information

NPI Number : 1104817105
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES D. MOONEY MD
Provider Business Mailing Address
First Line : 1316 SOUTH MAIN STREET
Second Line :
City : CLARION
State : IA
Zip : 50525-2019
Country : US
Telephone Number : 515-239-4496
Fax Number : 515-239-4767
Provider Business Practice Location Address
First Line : 1316 SOUTH MAIN STREET
Second Line :
City : CLARION
State : IA
Zip : 50525-2019
Country : US
Telephone Number : 515-532-2811
Fax Number : 515-532-9242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 12/26/2019

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Directions to “ DR. CHARLES D. MOONEY MD” Practice Location

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