Provider Demographics
NPI:1285694521
Name:MCDONALD, GREGORY A (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 S GILBERT ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4742
Mailing Address - Country:US
Mailing Address - Phone:319-338-2273
Mailing Address - Fax:319-338-1225
Practice Address - Street 1:943 S GILBERT ST
Practice Address - Street 2:SUITE 1
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4742
Practice Address - Country:US
Practice Address - Phone:319-338-2273
Practice Address - Fax:319-338-1225
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04746111N00000X
IA124111NN0400X
IA3036111NS0005X
IA2388111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA18549OtherWELLMARK BCBS
IA8103OtherMIDLAND'S CHOICE ID
IA1185496Medicaid
IA8103OtherMIDLAND'S CHOICE ID
IAI14723Medicare ID - Type UnspecifiedCLINIC ID
IA1185496Medicaid