Provider Demographics
NPI:1558390906
Name:TRAINER, TONY N (OD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:N
Last Name:TRAINER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 E LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:ALGONA
Mailing Address - State:IA
Mailing Address - Zip Code:50511-2039
Mailing Address - Country:US
Mailing Address - Phone:515-395-1221
Mailing Address - Fax:
Practice Address - Street 1:115 E CALL ST
Practice Address - Street 2:
Practice Address - City:ALGONA
Practice Address - State:IA
Practice Address - Zip Code:50511-2451
Practice Address - Country:US
Practice Address - Phone:515-295-2196
Practice Address - Fax:515-295-7964
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02317152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA02317OtherSTATE LICENSE #
IA1728246Medicaid
IA02317OtherSTATE LICENSE #
IA1728246Medicaid
IA5825000001Medicare NSC