Healthcare Provider Details

I. General information

NPI: 1164410932
Provider Name (Legal Business Name): IOWA HEART CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 UNIVERSITY AVE
WEST DES MOINES IA
50266-8220
US

IV. Provider business mailing address

5880 UNIVERSITY AVE SUITE 205
WEST DES MOINES IA
50266-8220
US

V. Phone/Fax

Practice location:
  • Phone: 515-633-3838
  • Fax: 515-633-3837
Mailing address:
  • Phone: 515-633-3838
  • Fax: 515-633-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number StateIA
# 6
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateIA
# 7
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateIA

VIII. Authorized Official

Name: JULIE YOUNGER
Title or Position: CHIEF FINANCIAL OFFICE
Credential:
Phone: 515-633-3970