Healthcare Provider Details

I. General information

NPI: 1073004156
Provider Name (Legal Business Name): JONATHAN CALVIN HECKART DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 PLEASANT ST STE 170
DES MOINES IA
50309-1424
US

IV. Provider business mailing address

1221 PLEASANT ST STE 170
DES MOINES IA
50309-1424
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-6886
  • Fax:
Mailing address:
  • Phone: 515-241-6886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number036181865
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberU5712
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberDO55742
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: