Provider Demographics
NPI:1679717615
Name:FALCO, JOSEPH JONATHAN (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JONATHAN
Last Name:FALCO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8860 NORTHPARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50131-3168
Mailing Address - Country:US
Mailing Address - Phone:515-349-1820
Mailing Address - Fax:515-349-1824
Practice Address - Street 1:8860 NORTHPARK DR STE 100
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50131-3168
Practice Address - Country:US
Practice Address - Phone:515-349-1820
Practice Address - Fax:515-349-1824
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-04589208000000X
NY255379208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics