Provider Demographics
NPI:1619948528
Name:SPRONK, DELMAR E (OD)
Entity Type:Individual
Prefix:DR
First Name:DELMAR
Middle Name:E
Last Name:SPRONK
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 1:928 3RD AVE
Mailing Address - Street 2:PO BOX 100
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-0100
Mailing Address - Country:US
Mailing Address - Phone:712-324-2552
Mailing Address - Fax:
Practice Address - Street 1:928 3RD AVE
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:IA
Practice Address - Zip Code:51201-0100
Practice Address - Country:US
Practice Address - Phone:712-324-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1630152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0280578Medicaid
IA1158659Medicaid
IA23060OtherMEDICARE DME INDIV ID-PAU
IACE1831OtherRR MEDICARE GROUP PAULLIN
IAI7585OtherMEDICARE GROUP PAULLINA
IAI7584OtherMEDICARE GROUP ID-SHELDON
IA33330OtherWELLMARK GROUP ID
IA0158659Medicaid
IA0280586Medicaid
IA15865OtherMEDICARE DME INDV ID-SHEL
IA23060OtherMEDICARE INDIVIDUAL PAULL
IA33340OtherWELLMARK GROUP ID
IACS7580OtherRR MEDICARE GROUP SHELDON
IACS7580OtherRR MEDICARE GROUP SHELDON
IA0245980001Medicare NSC
IA33330OtherWELLMARK GROUP ID
IA0158659Medicaid