Provider Demographics
NPI:1619382058
Name:HANGARTNER, MEGAN (OD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HANGARTNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:KRUCKENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 W MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2112
Mailing Address - Country:US
Mailing Address - Phone:319-385-9534
Mailing Address - Fax:319-385-9413
Practice Address - Street 1:301 W MONROE ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2112
Practice Address - Country:US
Practice Address - Phone:319-385-9534
Practice Address - Fax:319-385-9413
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073498152W00000X
TX8441T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist