MEDICARE: JOHN W MUSGRAVE 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
1	207Q00000X	Family Medicine Physician	25603	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275533143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN W MUSGRAVE MD

Provider Business Mailing Address
First Line	:	7024 NORDIC DR
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-6309
Country	:	US
Telephone Number	:	319-266-3127
Fax Number	:	319-266-5756

Provider Business Practice Location Address
First Line	:	7024 NORDIC DR
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-6309
Country	:	US
Telephone Number	:	319-266-3127
Fax Number	:	319-266-5756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	11/20/2018

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