Provider Demographics
NPI:1427642925
Name:DES MOINES REGENERATIVE MEDICINE PLLC
Entity type:Organization
Organization Name:DES MOINES REGENERATIVE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YANKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-225-4492
Mailing Address - Street 1:5901 WESTOWN PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8297
Mailing Address - Country:US
Mailing Address - Phone:515-225-4492
Mailing Address - Fax:
Practice Address - Street 1:17021 LAKESIDE HILLS PLZ STE 201
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2390
Practice Address - Country:US
Practice Address - Phone:402-506-6335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DES MOINES REGENERATIVE MEDICINE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty