Healthcare Provider Details

I. General information

NPI: 1023758638
Provider Name (Legal Business Name): MADISON LEYK DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 KENYON RD STE 310
FORT DODGE IA
50501-5746
US

IV. Provider business mailing address

804 KENYON RD STE 310
FORT DODGE IA
50501-5746
US

V. Phone/Fax

Practice location:
  • Phone: 515-302-8700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number130628
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: