Provider Demographics
NPI:1942269691
Name:DEENEY, DAVID (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DEENEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 E POST RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-7235
Mailing Address - Country:US
Mailing Address - Phone:319-373-4400
Mailing Address - Fax:319-373-4404
Practice Address - Street 1:1195 E POST RD UNIT 4
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-7235
Practice Address - Country:US
Practice Address - Phone:319-373-4400
Practice Address - Fax:319-373-4404
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00498213E00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1065789Medicaid
IAU00945Medicare UPIN
IAI8976Medicare ID - Type Unspecified