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

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

State licenses

LicenseStateTypeSpecialty
01992IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0057067MedicaidIA

Other providers in Mason City, IA

All providers in Mason City, IA · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Iowa

Sources for this page

Verify at the official NPI Registry.