Provider Demographics
NPI:1467564427
Name:SAATHOFF, MARK A (DPM)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:SAATHOFF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 23RD ST
Mailing Address - Street 2:
Mailing Address - City:FORT MADISON
Mailing Address - State:IA
Mailing Address - Zip Code:52627-4040
Mailing Address - Country:US
Mailing Address - Phone:319-372-2105
Mailing Address - Fax:319-372-1244
Practice Address - Street 1:702 23RD ST
Practice Address - Street 2:
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-4040
Practice Address - Country:US
Practice Address - Phone:319-372-2105
Practice Address - Fax:319-372-1244
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00447213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0253369Medicaid
T01438Medicare UPIN
0680690001Medicare NSC
IA0253369Medicaid