Provider Demographics
NPI:1194063974
Name:DR. GENE NOONAN INC
Entity type:Organization
Organization Name:DR. GENE NOONAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:DR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOONAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-556-8464
Mailing Address - Street 1:1641 ASBURY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-5729
Mailing Address - Country:US
Mailing Address - Phone:563-556-8464
Mailing Address - Fax:563-556-0879
Practice Address - Street 1:1641 ASBURY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-5729
Practice Address - Country:US
Practice Address - Phone:563-556-8464
Practice Address - Fax:563-556-0879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05341261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0091777Medicaid
IA0091777Medicaid