Individual
TERRY DALE VAN OORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
302 SW WALNUT ST, ANKENY, IA 50023-3042
(515) 229-0310
Mailing address
821 SE RICHLAND CIR, ANKENY, IA 50021-3650
(515) 229-0310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21660
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006775
—
IA
01
—
080175023
RAILROAD MEDICARE
—
01
—
18174
BC/BS OF IOWA
IA
05
—
3006775
—
IA
01
—
70990
WELLMARK BLUE SHIELD
IA
Enumeration date
01/29/2006
Last updated
08/09/2016
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