Provider Demographics
NPI:1578189296
Name:LINDA BRATKIEWICZ PODIATRY PLLC
Entity Type:Organization
Organization Name:LINDA BRATKIEWICZ PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SONNER
Authorized Official - Suffix:
Authorized Official - Credentials:CMA, RT(R)
Authorized Official - Phone:515-263-2474
Mailing Address - Street 1:1301 PENNSYLVANIA AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2364
Mailing Address - Country:US
Mailing Address - Phone:515-263-2474
Mailing Address - Fax:515-263-2478
Practice Address - Street 1:1301 PENNSYLVANIA AVE STE 115
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2364
Practice Address - Country:US
Practice Address - Phone:515-263-2474
Practice Address - Fax:515-263-2478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1881687408OtherINDIVIDUAL NPI