Provider Demographics
NPI:1639153059
Name:HOADLEY, DAVID CASH II (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CASH
Last Name:HOADLEY
Suffix:II
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 1:147 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-1218
Mailing Address - Country:US
Mailing Address - Phone:641-342-7436
Mailing Address - Fax:
Practice Address - Street 1:147 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1218
Practice Address - Country:US
Practice Address - Phone:641-342-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1933152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2152926Medicaid
IA4100035653OtherOSCEOLA
IA4100035655OtherCHARITON
IA342400OtherOSCEOLA
IA59380OtherBCBS OSCEOLA
IA0152926Medicaid
IA34212OtherBCBS OTTUMEA
IA59381OtherBCBS CHARITON
IA59380Medicare ID - Type UnspecifiedINDIVIDUAL
IAU00941Medicare UPIN
IA4100035655OtherCHARITON