Basic Information
| Provider Information | |||||||||
| NPI: | 1003801408 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOUNT | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | ALBERT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.P.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2459 E EUCLID AVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503173657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152625856 | ||||||||
| FaxNumber: | 5152626446 | ||||||||
| Practice Location | |||||||||
| Address1: | 2459 E EUCLID AVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503173657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152625856 | ||||||||
| FaxNumber: | 5152626446 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 09/04/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0131X | 510 | IA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0075762 | 05 | IA | MEDICAID |