Provider Demographics
NPI:1114907292
Name:MEHEGAN, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:MEHEGAN
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 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-399-3400
Mailing Address - Fax:319-399-3401
Practice Address - Street 1:540 E JEFFERSON ST STE 400
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2479
Practice Address - Country:US
Practice Address - Phone:319-339-3400
Practice Address - Fax:319-399-3401
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-27268207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2111856Medicaid
060037186OtherRR MEDICARE
54371OtherWELLMARK
71960OtherMEDICARE GROUP
CA3899OtherRR MEDICARE GROUP
71960OtherMEDICARE GROUP
E75275Medicare UPIN