Fackrell, Scott P

Fackrell, Scott P is an individual health care provider with primary practice located at 6000 University Ave Suite 101, West Des Moines IA 50266-8203. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Fackrell, Scott P can be contacted via phone (515) 241-2600.

Contact Information

Primary practice address
6000 University Ave Suite 101 West Des Moines IA 50266-8203
Phone: (515) 241-2600
Fax: (515) 241-2032
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02977 Iowa

Profile Details

NPI number 1669459533
LBN Legal business name Fackrell, Scott P
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Aug 30th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669459533 NPPES
Iowa MEDICAID 0130096
Iowa MEDICAID 1130096
Iowa MEDICAID 2130096

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