Healthcare Provider Details

I. General information

NPI: 1598955817
Provider Name (Legal Business Name): IOWA ORTHOPAEDIC CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 JEFFERSON ST
PELLA IA
50219-1255
US

IV. Provider business mailing address

450 LAUREL ST STE A
DES MOINES IA
50314-3045
US

V. Phone/Fax

Practice location:
  • Phone: 641-621-1390
  • Fax: 641-621-1394
Mailing address:
  • Phone: 515-247-8400
  • Fax: 515-248-8888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JAMIE MCDONALD
Title or Position: CEO
Credential:
Phone: 515-247-8400