Organization
SOUTHEAST IOWA ORTHOPEDICS & SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W HENDRICKS MD (CEO)
(319) 758-9133
Entity
Organization
Contact information
Practice address
903 OAK ST, BURLINGTON, IA 52601-4608
(319) 758-9133
(319) 758-9143
Mailing address
PO BOX 156, BURLINGTON, IA 52601-0156
(319) 758-9133
(319) 758-9143
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
26178
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043539
—
IA
01
—
10954
MIDLANDS CHOICE
IA
01
—
267960871
MEDICAID ILLINOIS
IA
01
—
30001
IAHS
IA
01
—
46204
BCBS
IA
01
—
470000991
MEDICARE RAILROAD
—
Enumeration date
11/05/2007
Last updated
04/16/2025
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