| Mercyone Des Moines Plastic & Reconstructive Surgery | |
|
1601 Nw 114th St Ste 151 Clive IA 50325-7046 | |
| (515) 643-5455 | |
| (515) 643-6459 |
| Full Name | Mercyone Des Moines Plastic & Reconstructive Surgery |
|---|---|
| Speciality | Clinic/center |
| Location | 1601 Nw 114th St Ste 151, Clive, Iowa |
| Authorized Official Name and Position | Bradley Whipple (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5153586956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercyone Des Moines Plastic & Reconstructive Surgery Po Box 1475 Des Moines IA 50305-1475 Ph: (515) 643-5455 | Mercyone Des Moines Plastic & Reconstructive Surgery 1601 Nw 114th St Ste 151 Clive IA 50325-7046 Ph: (515) 643-5455 |
| NPI Number | 1699067397 |
|---|---|
| Provider Enumeration Date | 05/12/2011 |
| Last Update Date | 10/11/2024 |
| Certification Date | 10/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699067397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Iowa) | Primary |
| 363A00000X | Physician Assistant | () | Secondary |
| 2086S0122X | Surgery - Plastic And Reconstructive Surgery | () | Secondary |
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