Provider Demographics
NPI:1750333464
Name:O'SHEA, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:O'SHEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:915 13TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-5067
Mailing Address - Country:US
Mailing Address - Phone:563-243-2511
Mailing Address - Fax:563-243-0817
Practice Address - Street 1:915 13TH AVE N
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-5067
Practice Address - Country:US
Practice Address - Phone:563-243-2511
Practice Address - Fax:563-243-0817
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21427207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
018412OtherHEALTH ALLIANCE
IA20792OtherWELLMARK BC/BS
27123OtherIOWA HEALTH SOLUTIONS
IA0161083Medicaid
IL0300676062Medicaid
IA0117OtherJOHN DEERE HEALTH
IL09822109OtherBLUE CROSS/BLUE SHIELD
19347OtherMIDLANDS CHOICE
IL0300676062Medicaid
27123OtherIOWA HEALTH SOLUTIONS
IA20792OtherWELLMARK BC/BS
IA20792Medicare PIN