Healthcare Provider Details

I. General information

NPI: 1366465262
Provider Name (Legal Business Name): HEARTLAND PODIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1048 WOODLAND PARK DR
WEST DES MOINES IA
50266-4948
US

IV. Provider business mailing address

1048 WOODLAND PARK DR
WEST DES MOINES IA
50266-4948
US

V. Phone/Fax

Practice location:
  • Phone: 515-401-8471
  • Fax: 515-401-8471
Mailing address:
  • Phone: 515-401-8471
  • Fax: 515-401-8471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00425
License Number StateIA

VIII. Authorized Official

Name: DR. BRUCE ARTHUR PICHLER
Title or Position: OWNER
Credential: D.P.M.
Phone: 515-401-8471