Provider Demographics
NPI:1437254745
Name:NOBLE, HENRY GEORGE S (MD)
Entity Type:Individual
Prefix:
First Name:HENRY GEORGE
Middle Name:S
Last Name:NOBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GEORGE
Other - Middle Name:S
Other - Last Name:NOBLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4925
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-4925
Mailing Address - Country:US
Mailing Address - Phone:515-643-5454
Mailing Address - Fax:515-643-5460
Practice Address - Street 1:330 LAUREL ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3034
Practice Address - Country:US
Practice Address - Phone:515-643-5454
Practice Address - Fax:515-643-5460
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA353382086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0420158Medicaid
IA36048OtherWELLMARK
IAIA0143OtherJOHN DEERE
IA106070OtherHEALTH ALLIANCE
IA186631OtherCOVENTRY
IAC11016Medicare UPIN
IAIA0143OtherJOHN DEERE