Provider Demographics
NPI:1265835474
Name:IOWA FOOT & ANKLE SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:IOWA FOOT & ANKLE SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:TROTTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:563-424-1235
Mailing Address - Street 1:2884 AAA CT
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3406
Mailing Address - Country:US
Mailing Address - Phone:563-424-1235
Mailing Address - Fax:563-424-1236
Practice Address - Street 1:2884 AAA CT
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3406
Practice Address - Country:US
Practice Address - Phone:563-424-1235
Practice Address - Fax:563-424-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB3247Medicare UPIN