Dr. Jim Paul Licandro, DPM
Dr. Jim Paul Licandro, DPM is a Podiatrist in Long Grove, Iowa. Licensed in Iowa. Registered with an NPI since 2005.
- Licensed in
- IA
- In the registry since
- 2005
What do these letters mean?
- DPM — Doctor of Podiatric Medicine
- A foot and ankle physician and surgeon.
Practice location Address checks out
405 Woodlawn RdLong Grove, IA 52756
Phone: (832) 425-7457
Fax: (563) 285-5446
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Podiatrist (primary) | Taxonomy 213E00000X · Licence 00705 (IA) |
|---|
Record details
| NPI number | 1609873538 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | DPM |
| Sole proprietor | No |
| NPI enumerated | July 7, 2005 |
| Last updated in NPPES | July 22, 2018 |
| Mailing address | 5261 Boulder Dr Apt D, West Des Moines, IA 50265-7823 |
Other providers in Long Grove
-
Premier Podiatry
405 Woodlawn Rd, Long Grove, IA 52756-8745 · (832) 425-7457