Provider Demographics
NPI:1326374414
Name:DROWN, ROGER C (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:C
Last Name:DROWN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1936
Mailing Address - Country:US
Mailing Address - Phone:712-243-3250
Mailing Address - Fax:712-243-7587
Practice Address - Street 1:1501 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1936
Practice Address - Country:US
Practice Address - Phone:712-243-3250
Practice Address - Fax:712-243-7587
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000827213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1912278490Medicaid
IA1912278490OtherWELLMARK BCBS
IAP01144523OtherRR MEDICARE
IA1912278490Medicaid