Provider Demographics
NPI:1144317587
Name:LOVELESS, JOEL EDWARD (DO)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:EDWARD
Last Name:LOVELESS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4846 CANDLEWICK DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-1852
Mailing Address - Country:US
Mailing Address - Phone:515-953-6216
Mailing Address - Fax:
Practice Address - Street 1:802 KENYON RD
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5740
Practice Address - Country:US
Practice Address - Phone:515-574-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H33277Medicare UPIN