Healthcare Provider Details

I. General information

NPI: 1164352845
Provider Name (Legal Business Name): GEORGE EDWARD BEDDOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1415 WOODLAND AVE STE 140
DES MOINES IA
50309-3203
US

IV. Provider business mailing address

1415 WOODLAND AVE STE 140
DES MOINES IA
50309-3203
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-4078
  • Fax:
Mailing address:
  • Phone: 515-241-4078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR-13767
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: