Individual
JOHN D TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 DIAMOND ST, ONAWA, IA 51040-1548
(712) 423-2311
(712) 423-9362
Mailing address
PO BOX 241279, OMAHA, NE 68124-5279
(402) 397-1531
(402) 397-0456
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
15071
NE
2085R0202X
Diagnostic Radiology Physician
Primary
22564
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7914150
—
IA
Enumeration date
10/24/2006
Last updated
08/15/2007
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