Provider Demographics
NPI:1588642615
Name:OHEARN, MAURICE SHAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:SHAWN
Last Name:OHEARN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50595-1438
Mailing Address - Country:US
Mailing Address - Phone:515-297-2837
Mailing Address - Fax:
Practice Address - Street 1:639 2ND ST
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-1438
Practice Address - Country:US
Practice Address - Phone:515-297-2837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA44144OtherWELLMARK BC/BS
IA1208496Medicaid
IA44144OtherWELLMARK BC/BS