Provider Demographics
NPI:1386653707
Name:RAHNER, KEVIN (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:RAHNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-8100
Mailing Address - Fax:515-643-8139
Practice Address - Street 1:3815 STANGE RD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3914
Practice Address - Country:US
Practice Address - Phone:515-956-4044
Practice Address - Fax:515-956-4075
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03018207Q00000X
IADO-03018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA71564OtherWELLMARK BLUE SHIELD
IA0463802Medicaid
IA0463802Medicaid
IA22655001Medicare PIN
IA71564OtherWELLMARK BLUE SHIELD