Provider Demographics
NPI:1225098759
Name:HEILSKOV, TODD WHITNEY (MD)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:WHITNEY
Last Name:HEILSKOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1501 50TH ST
Mailing Address - Street 2:STE 133
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266
Mailing Address - Country:US
Mailing Address - Phone:575-222-6400
Mailing Address - Fax:515-222-6406
Practice Address - Street 1:1501 50TH ST
Practice Address - Street 2:STE 133
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:575-222-6400
Practice Address - Fax:515-222-6406
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA27668207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0083691Medicaid
08157Medicare ID - Type Unspecified
IA0083691Medicaid