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General NPI Number Information
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NPI Number | 1467686139
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Entity Type | Organization
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Legal Business Name | CAPITAL ORTHOPAEDICS AND SPORTS MEDICINE LLP
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 1601 NW 114TH ST SUITE 142
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City | DES MOINES
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State | IA
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Zip | 50325-7007
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Country | US
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Telephone | 515-440-2676
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Fax | 515-440-2677
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Provider Business Mailing Address
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Address Line | 1601 NW 114TH ST SUITE 142
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City | DES MOINES
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State | IA
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Zip | 50325-7007
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Country | US
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Telephone | 515-440-2676
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Fax | 515-440-2677
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Authorized Official
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Title or Position | PARTNER
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Name | DR. WILLIAM CHARLES JACOBSON
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Credential | MD
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Telephone | 515-440-2676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00693
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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