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Organization
CAPITAL ORTHOPAEDICS AND SPORTS MEDICINE PC
Active
Organization
CAPITAL ORTHOPAEDICS AND SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM CHARLES JACOBSON MD (SHAREHOLDER)
(515) 440-2676
Entity
Organization
Contact information
Practice address
12499 UNIVERSITY AVE, SUITE 210, CLIVE, IA 50325-8281
(515) 440-2676
(515) 440-2677
Mailing address
12499 UNIVERSITY AVE, SUITE 210, CLIVE, IA 50325-8281
(515) 440-2676
(515) 440-2677
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
IA
207XS0106X
Orthopaedic Hand Surgery Physician
26239
IA
207XS0117X
Orthopaedic Surgery of the Spine Physician
19337
IA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
33389
IA
208100000X
Physical Medicine & Rehabilitation Physician
27587
IA
2086S0105X
Surgery of the Hand (Surgery) Physician
37744
IA
213ES0103X
Foot & Ankle Surgery Podiatrist
00693
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932432457
—
IA
Enumeration date
09/16/2009
Last updated
01/22/2013
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