MEDICARE: DR. JANE WANG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	22284	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518955905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE WANG M.D.

Provider Business Mailing Address
First Line	:	7025 HICKMAN RD
Second Line	:	SUITE 1
City	:	DES MOINES
State	:	IA
Zip	:	50322-4843
Country	:	US
Telephone Number	:	515-270-2486
Fax Number	:	515-270-8512

Provider Business Practice Location Address
First Line	:	7025 HICKMAN RD
Second Line	:	SUITE 1
City	:	DES MOINES
State	:	IA
Zip	:	50322-4843
Country	:	US
Telephone Number	:	515-270-2486
Fax Number	:	515-270-8512

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. JANE WANG M.D.” Practice Location

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