Healthcare Provider Details

I. General information

NPI: 1851190276
Provider Name (Legal Business Name): JOHN BUTCHKO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309-1406
US

IV. Provider business mailing address

950 JORDAN CREEK PKWY APT 341
WEST DES MOINES IA
50266-6044
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-5586
  • Fax:
Mailing address:
  • Phone: 424-280-6485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR-13967
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: