Provider Demographics
NPI:1427169051
Name:BOCHMANN, COURTNEY C (DO)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:C
Last Name:BOCHMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 9TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2999
Mailing Address - Country:US
Mailing Address - Phone:319-483-1390
Mailing Address - Fax:319-483-1399
Practice Address - Street 1:312 9TH ST SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2999
Practice Address - Country:US
Practice Address - Phone:319-483-1390
Practice Address - Fax:319-483-1399
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-7289207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1427169051Medicaid
IA1427169051Medicaid