Provider Demographics
NPI:1073951570
Name:COURTNEY, PATRICK ALAN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:ALAN
Last Name:COURTNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 4TH ST SW STE 240
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2856
Mailing Address - Country:US
Mailing Address - Phone:641-428-7766
Mailing Address - Fax:641-428-7125
Practice Address - Street 1:1010 4TH ST SW STE 240
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2856
Practice Address - Country:US
Practice Address - Phone:641-428-7766
Practice Address - Fax:641-428-7125
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6942207Q00000X
IAMD-42566207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine