Provider Demographics
NPI:1922082056
Name:SALOCKER, RICK P (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:P
Last Name:SALOCKER
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 1:2700 1ST AVE S STE 400
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4300
Mailing Address - Country:US
Mailing Address - Phone:515-576-3338
Mailing Address - Fax:515-576-4558
Practice Address - Street 1:2700 1ST AVE S STE 400
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4300
Practice Address - Country:US
Practice Address - Phone:515-576-3338
Practice Address - Fax:515-576-4558
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00345213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA480013830OtherRAILROAD MEDICARE
IAI7688OtherMEDICARE GROUP
IA0298471OtherMEDICAID GROUP
IA11311OtherWELLMARK BCBS OF IOWA
IA2151464Medicaid
T00909Medicare UPIN
IA0631990002Medicare NSC
11311Medicare PIN