Individual
DONALD E MCKIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1610 W TOWNLINE ST, STE 115, CRESTON, IA 50801-1064
(641) 782-7619
(641) 782-6549
Mailing address
PO BOX 427, CRESTON, IA 50801-0427
(641) 782-7619
(641) 782-6549
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01847
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0037465
—
IA
01
—
01847
IOWA LICENSE
IA
01
—
24565
BLUE CROSS BLUE SHIELD
IA
Enumeration date
06/09/2005
Last updated
11/27/2007
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