Provider Demographics
NPI:1720340524
Name:WAITE, CURTIS J (DO)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:J
Last Name:WAITE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1215 DUFF AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-2155
Mailing Address - Fax:515-239-2050
Practice Address - Street 1:1111 DUFF AVENUE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3014
Practice Address - Country:US
Practice Address - Phone:515-239-2155
Practice Address - Fax:515-239-2050
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IA04809207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program