Healthcare Provider Details

I. General information

NPI: 1538119755
Provider Name (Legal Business Name): SEYMOUR FOOT & ANKLE CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S WHITE ST SUITE 27
MT PLEASANT IA
52641-2600
US

IV. Provider business mailing address

501 S WHITE ST SUITE 27
MT PLEASANT IA
52641-2600
US

V. Phone/Fax

Practice location:
  • Phone: 319-385-6756
  • Fax: 319-385-6759
Mailing address:
  • Phone: 319-385-6756
  • Fax: 319-385-6759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TIFFANY A HAUPTMAN
Title or Position: OWNER
Credential: DPM
Phone: 319-385-6756