Basic Information
Provider Information
NPI: 1689952210
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOOBAY
FirstName: MARC
MiddleName: FRANK
NamePrefix:  
NameSuffix:  
Credential: MPAS, PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3194672000
FaxNumber: 3194672814
Practice Location
Address1: 920 E 2ND AVE STE 201B
Address2:  
City: CORALVILLE
State: IA
PostalCode: 522412225
CountryCode: US
TelephoneNumber: 3194672000
FaxNumber: 3194672814
Other Information
ProviderEnumerationDate: 08/01/2011
LastUpdateDate: 08/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X002241IAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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