Provider Demographics
NPI:1609452150
Name:FOOT AND ANKLE OF GREATER DES MOINES, PC
Entity Type:Organization
Organization Name:FOOT AND ANKLE OF GREATER DES MOINES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, OWNER, OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-493-6981
Mailing Address - Street 1:550 36TH AVE SW STE F
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-2626
Mailing Address - Country:US
Mailing Address - Phone:515-631-9567
Mailing Address - Fax:515-349-8578
Practice Address - Street 1:550 36TH AVE SW STE F
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-2626
Practice Address - Country:US
Practice Address - Phone:515-631-9567
Practice Address - Fax:515-243-2057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty