Provider Demographics
NPI:1457464836
Name:DOOLITTLE, GRANT DENNIS (DO)
Entity Type:Individual
Prefix:
First Name:GRANT
Middle Name:DENNIS
Last Name:DOOLITTLE
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 3014
Mailing Address - Street 2:1215 DUFF AVE MCFARLAND CLINIC PC
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-4400
Mailing Address - Fax:515-239-4446
Practice Address - Street 1:1215 DUFF AVE
Practice Address - Street 2:MCFARLAND CLINIC PC
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3014
Practice Address - Country:US
Practice Address - Phone:515-239-4431
Practice Address - Fax:515-239-4742
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1457464836Medicaid
IAI20334Medicare PIN