Provider Demographics
NPI:1689655169
Name:HAND, DOUGLAS DEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:DEAN
Last Name:HAND
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 1:201 S. CLINTON
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240
Mailing Address - Country:US
Mailing Address - Phone:319-338-7952
Mailing Address - Fax:319-338-6931
Practice Address - Street 1:201 S. CLINTON
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240
Practice Address - Country:US
Practice Address - Phone:319-338-7952
Practice Address - Fax:319-338-6931
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01875152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0270231Medicaid
IAT80081Medicare UPIN
IA04934Medicare PIN
IAI8022Medicare ID - Type UnspecifiedMEDICARE