Daniel J Waters, D.O.
Individual provider Active NPI Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Mason City, IA
NPI 1962490136 · NPPES record last updated Jan 23, 2018
Key facts
- NPI
- 1962490136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
- License
- 01992 (IA)
- Practice address
- 250 S Crescent Dr
Mason City, IA 50401-2926 - Phone
- (641) 494-5300
- Fax
- (641) 494-5321
- NPI assigned
- Oct 11, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01992 | IA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 01992 | IA | Yes |
Addresses
Primary practice location
250 S Crescent Dr
Mason City, IA 50401-2926
Mailing address
250 S Crescent Dr
Mason City, IA 50401-2926
Phone (641) 494-5400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0057067 | Medicaid | IA |
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All providers in Mason City, IA · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.