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General NPI Number Information
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NPI Number | 1447586102
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Entity Type | Organization
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Legal Business Name | CENTRAL IOWA PEDIATRIC ALLERGY & PULMONOLOGY, PLLC
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Dates
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Enumeration Date | 10/30/2009
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 7029 VISTA DR
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City | WEST DES MOINES
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State | IA
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Zip | 50266-9311
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Country | US
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Telephone | 515-868-0220
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Fax | 515-223-3022
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Provider Business Mailing Address
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Address Line | 7029 VISTA DR
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City | WEST DES MOINES
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State | IA
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Zip | 50266-9311
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Country | US
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Telephone | 515-868-0220
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Fax | 515-223-3022
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT JAMES SHEETS
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Credential | D.O.
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Telephone | 515-208-7912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 02934
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License Number State | IA
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