Provider Demographics
NPI:1861634008
Name:ALVIS, NATHANIEL VAUGHN (DO)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:VAUGHN
Last Name:ALVIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:IA
Mailing Address - Zip Code:51529-1336
Mailing Address - Country:US
Mailing Address - Phone:712-643-2298
Mailing Address - Fax:712-643-5630
Practice Address - Street 1:707 IOWA AVE
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:IA
Practice Address - Zip Code:51529-1335
Practice Address - Country:US
Practice Address - Phone:712-643-2298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE756207Q00000X
IA4148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine