Dwain G Crain, DO

Individual provider Active NPI Family Medicine Physician · Mount Ayr, IA

NPI 1649250002 · NPPES record last updated Nov 17, 2009

Key facts

NPI
1649250002
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
02084 (IA)
Practice address
207 N Taylor St
Mount Ayr, IA 50854-1635
Phone
(641) 464-3911
Fax
(641) 464-2939
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2084IAMDOptometrist
02084IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crain Medical Clinic Family Medicine Past
since Mar 6, 2012
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02084 IA Yes

Addresses

Primary practice location

207 N Taylor St
Mount Ayr, IA 50854-1635

Mailing address

207 N Taylor St
Mount Ayr, IA 50854-1635
Phone (641) 464-3911

Other identifiers

IdentifierTypeStateIssuer
0226704MedicaidIA

Other providers in Mount Ayr, IA

All providers in Mount Ayr, IA · Family Medicine Physician in Iowa

Sources for this page

Verify at the official NPI Registry.