Healthcare Provider Details

I. General information

NPI: 1063666089
Provider Name (Legal Business Name): SARAH ELIZABETH POLK D.P.M
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E 9TH ST
CORALVILLE IA
52241-2209
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-467-2000
  • Fax: 319-467-2915
Mailing address:
  • Phone: 319-467-2000
  • Fax: 319-467-2915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number000833
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number000833
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: