Healthcare Provider Details

I. General information

NPI: 1033162706
Provider Name (Legal Business Name): ENT CLINIC OF IOWA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/24/2020
Certification Date: 08/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 WESTOWN PKWY STE 360
WEST DES MOINES IA
50266-7306
US

IV. Provider business mailing address

2600 WESTOWN PKWY STE 360
WEST DES MOINES IA
50266-7306
US

V. Phone/Fax

Practice location:
  • Phone: 515-267-1800
  • Fax: 515-267-8857
Mailing address:
  • Phone: 515-267-1800
  • Fax: 515-267-8857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DOUGLAS R HOISINGTON
Title or Position: OWNER OF ENT CLINIC OF IA
Credential: D.O.
Phone: 515-267-1800