Provider Demographics
NPI:1285608018
Name:VEATCH, MARLIN ARTHUR (OD)
Entity type:Individual
Prefix:DR
First Name:MARLIN
Middle Name:ARTHUR
Last Name:VEATCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 CORAL CT
Mailing Address - Street 2:SUITE #5
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2872
Mailing Address - Country:US
Mailing Address - Phone:319-665-2727
Mailing Address - Fax:877-335-3515
Practice Address - Street 1:2441 CORAL CT
Practice Address - Street 2:SUITE #5
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2872
Practice Address - Country:US
Practice Address - Phone:319-665-2727
Practice Address - Fax:877-335-3515
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1548152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
410027930OtherRAILROAD MEDICARE
IA0067082Medicaid
U22464Medicare UPIN
410027930OtherRAILROAD MEDICARE