Mahoney, Larry T

Mahoney, Larry T is an individual health care provider with primary practice located at 200 Hawkins Dr , Iowa City IA 52242-1009. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Mahoney, Larry T can be contacted via phone (319) 356-2837.

Contact Information

Primary practice address
200 Hawkins Dr Iowa City IA 52242-1009
Fax: (319) 356-4693
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 19379 Iowa

Profile Details

NPI number 1609862366
LBN Legal business name Mahoney, Larry T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Dec 12th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609862366 NPPES
Iowa Other 13173 WELLMARK BCBS
Iowa MEDICAID 0131730 WELLMARK BCBS

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