Healthcare Provider Details

I. General information

NPI: 1609494673
Provider Name (Legal Business Name): DES MOINES ORTHOPAEDIC SURGEONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 4TH AVE
GRINNELL IA
50112-1898
US

IV. Provider business mailing address

6001 WESTOWN PKWY
WEST DES MOINES IA
50266-7702
US

V. Phone/Fax

Practice location:
  • Phone: 515-224-1414
  • Fax:
Mailing address:
  • Phone: 515-224-5130
  • Fax: 515-224-5140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS J HONKAMP
Title or Position: PRESIDENT
Credential:
Phone: 515-224-1414