Provider Demographics
NPI:1942835707
Name:TROUTNER, DANIEL DOUGLAS
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:DOUGLAS
Last Name:TROUTNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-9509
Mailing Address - Country:US
Mailing Address - Phone:319-338-3606
Mailing Address - Fax:
Practice Address - Street 1:2751 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9509
Practice Address - Country:US
Practice Address - Phone:319-338-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA109228363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant