Provider Demographics
NPI:1477592954
Name:DOLPHIN, TODD F (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:F
Last Name:DOLPHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 N CENTER POINT RD
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-1226
Mailing Address - Country:US
Mailing Address - Phone:319-294-3668
Mailing Address - Fax:319-365-6974
Practice Address - Street 1:754 N CENTER POINT RD
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1226
Practice Address - Country:US
Practice Address - Phone:319-294-3668
Practice Address - Fax:319-294-4271
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00730213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051503799Medicaid
IAU81873Medicare UPIN
AL051503799Medicaid