Organization
HEARTLAND VASCULAR MEDICINE AND SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN RUSSELL KOSLOW M.D, F.A.C.S (OWNER)
(515) 284-1976
Entity
Organization
Contact information
Practice address
974 73RD ST, SUITE 23, WINDSOR HEIGHTS, IA 50324-1024
(515) 284-1976
(515) 223-3010
Mailing address
974 73RD ST, SUITE 23, WINDSOR HEIGHTS, IA 50324-1024
(515) 284-1976
(515) 223-3010
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
30390
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2119164
—
IA
01
—
38295
WELLMARK
IA
Enumeration date
12/19/2006
Last updated
06/02/2010
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