Provider Demographics
NPI:1982608584
Name:HAUPTMAN, TIFFANY A S (DPM)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:A S
Last Name:HAUPTMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ANN
Other - Last Name:SEYMOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:501 S WHITE ST
Mailing Address - Street 2:STE 27
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2600
Mailing Address - Country:US
Mailing Address - Phone:319-385-6756
Mailing Address - Fax:319-385-6759
Practice Address - Street 1:501 S WHITE ST
Practice Address - Street 2:STE 27
Practice Address - City:MOUNT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2600
Practice Address - Country:US
Practice Address - Phone:319-385-6756
Practice Address - Fax:319-385-6759
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00671213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0212472Medicaid
IA480030686OtherRAILROAD MEDICARE
IA20069OtherWELLMARK BC/BS
IAI19341Medicare PIN
IA0212472Medicaid