Healthcare Provider Details

I. General information

NPI: 1225098759
Provider Name (Legal Business Name): TODD WHITNEY HEILSKOV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 50TH ST STE 133
WEST DES MOINES IA
50266
US

IV. Provider business mailing address

1501 50TH ST STE 133
WEST DES MOINES IA
50266
US

V. Phone/Fax

Practice location:
  • Phone: 515-222-6400
  • Fax: 515-225-8921
Mailing address:
  • Phone: 575-222-6400
  • Fax: 515-225-8921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number27668
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: