Organization
RUDOLPH LAFONTANT, DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE SHUPE (CEO)
(515) 963-9464
Entity
Organization
Contact information
Practice address
1701 22ND ST STE 105, WEST DES MOINES, IA 50266-1443
(515) 963-9464
(515) 963-9467
Mailing address
1701 22ND ST STE 105, WEST DES MOINES, IA 50266-1443
(515) 963-9464
(515) 963-9467
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00597
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0415927
—
IA
01
—
0934390001
DMERC
IA
01
—
DE4738
RAILROAD MEDICARE
—
Enumeration date
10/26/2007
Last updated
09/02/2009
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