Healthcare Provider Details

I. General information

NPI: 1437360351
Provider Name (Legal Business Name): KYLE J ALLIMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 WESTOWN PKWY
WEST DES MOINES IA
50266-7705
US

IV. Provider business mailing address

309 E CHURCH ST
MARSHALLTOWN IA
50158-2946
US

V. Phone/Fax

Practice location:
  • Phone: 800-542-7956
  • Fax: 641-754-6245
Mailing address:
  • Phone: 641-754-6262
  • Fax: 641-752-7420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number39020
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME101982
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number39020
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: