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Dr. Jim Paul Licandro, DPM
Podiatrist in Long Grove, Iowa
NPI 1609873538

Jim Paul Licandro is a Podiatrist based in West Des Moines, IA. Jim Paul Licandro practices in Long Grove, IA and has the professional credentials of DPM. The NPI Number for Jim Paul Licandro is 1609873538 and holds a License No. 00705 (Iowa).

The current practice location address for Jim Paul Licandro is 405 Woodlawn Rd, Long Grove, IA and can be reached out via phone at 832-425-7457 and via fax at 563-285-5446.

Location: 405 Woodlawn Rd, Long Grove, IA, 50265-7823
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1609873538
Provider Name
Jim Paul Licandro
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
405 Woodlawn Rd, Long Grove, IA, 50265-7823
Phone Number
832-425-7457
Fax Number
563-285-5446
Provider Enumeration Date
07/07/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1197210 05 IA
institution
Provider Business Practice Location Address Details
Address
405 Woodlawn Rd
City
Long Grove
State
Iowa
Zip
52756
Phone Number
832-425-7457
Fax Number
563-285-5446
person
Provider Business Mailing Address Details
Address
405 Woodlawn Rd
City
Long Grove
State
Iowa
Zip
52756
Phone Number
832-425-7457
Fax Number
563-285-5446
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
00705 (Iowa)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
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