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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