Individual
DR. MARY C OBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
115 S 29TH ST, SUITE A, FORT DODGE, IA 50501-2951
(515) 573-7401
(515) 576-8591
Mailing address
1171 FOXRIDGE DR, FORT DODGE, IA 50501-7158
(515) 573-5895
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1984
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0213410102
DMERC
IA
05
—
2086660
—
IA
01
—
36672
BLUE CROSS BLUE SHIELD
IA
01
—
P00278463
RAILROAD MEDICARE
IA
Enumeration date
03/17/2006
Last updated
03/27/2008
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