Provider Demographics
NPI:1497747299
Name:SCALLON, LOUIS J (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:J
Last Name:SCALLON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:309 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2946
Mailing Address - Country:US
Mailing Address - Phone:641-754-6200
Mailing Address - Fax:641-752-7420
Practice Address - Street 1:2020 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8772
Practice Address - Country:US
Practice Address - Phone:515-232-2450
Practice Address - Fax:515-232-3532
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2015-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA26457207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA180027519OtherRAILROAD MEDICARE
IAA03669Medicare UPIN