Provider Demographics
NPI:1942265822
Name:ROBERT & DAWN LAGONE DPM PC
Entity Type:Organization
Organization Name:ROBERT & DAWN LAGONE DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNET SECURITY / BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TELETHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAXSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-263-0000
Mailing Address - Street 1:2220 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-5442
Mailing Address - Country:US
Mailing Address - Phone:563-263-0000
Mailing Address - Fax:563-263-5113
Practice Address - Street 1:2220 PARK AVE
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-5442
Practice Address - Country:US
Practice Address - Phone:563-263-0000
Practice Address - Fax:563-263-5113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IACN8848OtherRAILROAD MEDICARE
IA0444695Medicaid
IAI8750Medicare PIN
IA0444695Medicaid
480016741Medicare PIN
480023818Medicare PIN