Individual
ALAN RANDAL BOLLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3509 E 29TH ST, DES MOINES, IA 50317
(515) 248-1600
(515) 248-1610
Mailing address
1200 UNIVERSITY AVE, STE 200, DES MOINES, IA 50314-2355
(515) 248-1447
(515) 248-1440
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
DO-02348
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0421628
—
IA
01
—
1295830115
MEDICARE PTAN IB3072001
IA
Enumeration date
09/14/2006
Last updated
05/31/2018
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