Individual
GREGORY C MCKERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1355 50TH ST, SUITE 100, WEST DES MOINES, IA 50266-1617
(515) 225-3261
(515) 225-1944
Mailing address
1355 50TH ST, SUITE 100, WEST DES MOINES, IA 50266-1617
(515) 225-3261
(515) 225-1944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO-02827
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38887
BCBS
IA
01
—
38969
BCBS
IA
05
—
4105601
—
IA
05
—
5105601
—
IA
01
—
P00246380
TRAVELERS MEDICARE
IA
Enumeration date
01/17/2006
Last updated
02/28/2019
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