Premier Podiatry - Podiatrist in Long Grove, IA

Premier Podiatry is a Podiatrist based in Long Grove, Iowa. Premier Podiatry is licensed to practice in Iowa (license number 0705) and their current practice location is 405 Woodlawn Rd, Long Grove, Iowa. It can be reached at their office (for appointments etc.) via phone at (832) 425-7457.

NPI number for Premier Podiatry is 1720445281 and their current mailing address is Po Box 2671, Davenport, Iowa. Premier Podiatry does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1720445281.

Contact Information

Premier Podiatry
405 Woodlawn Rd,
Long Grove, IA 52756-8745
(832) 425-7457
(563) 424-7234



Healthcare Provider's Profile

Full NamePremier Podiatry
TypeFacility
SpecialityPodiatrist
Location405 Woodlawn Rd, Long Grove, Iowa
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1720445281
  • Provider Enumeration Date: 01/28/2016
  • Last Update Date: 07/21/2022

Medical Identifiers

Medical identifiers for Premier Podiatry such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1720445281NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
213E00000XPodiatrist 0705 (Iowa)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Premier Podiatry is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Premier Podiatry
Po Box 2671,
Davenport, IA 52809-2671

Ph: (832) 425-7457
Premier Podiatry
405 Woodlawn Rd,
Long Grove, IA 52756-8745

Ph: (832) 425-7457

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› Verified 7 days ago


Podiatrist in Long Grove, IA

Dr. Jim Paul Licandro, DPM
Podiatrist
Medicare: Not Enrolled in Medicare
Practice Location: 405 Woodlawn Rd, Long Grove, IA 52756
Phone: 832-425-7457    Fax: 563-285-5446

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