DR. THOMAS A. MALLISEE III (NPI# 1639167042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639167042 |
| Entity Type | Individual |
| Full Name | DR. THOMAS A. MALLISEE III |
| Credential | M.D. |
| Practice Address |
1111 6th Ave Des Moines IA 50314-2613 |
| Practice Telephone | 5156432667 |
| Practice Fax Number | 5156432978 |
| Mailing Telephone | 5156432667 |
| Mailing Fax Number | 5156432978 |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
32854 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0192344 | 05 |
| Street Address |
1111 6TH AVE |
| City | DES MOINES |
| State | IA |
| Zip Code | 50314-2613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790785004 | Keven Odell Cutler | Emergency Medicine | 1111 6th Ave, Emergency Dept, Des Moines, IA 50314-2613 | 2005-07-28 |
| 1508470014 | Tammie Jordan | Pharmacist | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-09-02 |
| 1942812243 | Samantha Marie Ulsh | Nurse Practitioner | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-08-18 |
| 1962020677 | Jordyn Hauser | Dietitian, Registered | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-07-09 |
| 1659996528 | Doh Joon Park | Internal Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-16 |
| 1508481623 | Maianh T Tran | Surgery | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-15 |
| 1083239081 | Max E Reiche | Family Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-15 |
| 1760007488 | Obidike P Nwadike | Family Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-09 |
| 1154945970 | Jason C Wang | Internal Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-08 |
| 1588288435 | Elliot M Deblieck | Family Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982266979 | Dental Connections, Inc. | Dentist | 1111 9th Street, Suite 190, Des Moines, IA 50314 | 2019-07-01 |
| 1760910723 | Kelsey Taylor | Social Worker | 1761 Hickman Rd, Des Moines, IA 50314 | 2017-06-02 |
| 1184085672 | Allison J Robbins | Counselor | 1063 14th Place, Suite A, Des Moines, IA 50314 | 2016-03-11 |
| 1083081715 | Taylor Witzel | Specialist/Technologist | 450 Laurel Street, Des Moines, IA 50314 | 2015-08-28 |
| 1376893933 | Caring Hearts LLC | In Home Supportive Care | 1620 Pleasant, #245, Des Moines, IA 50314 | 2012-09-11 |
| 1104117522 | Akinbode Solomon Egbelakin | Pediatrics | 1111 6th Ave # Main3, Des Moines, IA 50314 | 2011-04-20 |
| 1447488325 | Abdelaziz Elhaddad | Internal Medicine | 95 University Avenue, Suite 1, Des Moines, IA 50314 | 2009-06-30 |
| 1356584080 | Tara Michelle Graff | Internal Medicine | 411 Laurel Street Suite A300, Des Moines, IA 50314 | 2009-04-10 |
| 1700068517 | Planned Parenthood of The Heartland | Family Medicine | 123 Clark Street, Des Moines, IA 50314 | 2007-12-04 |
| 1790903235 | Christy J. Meyer | Counselor | 1063 14th Place, Suite A, Des Moines, IA 50314 | 2007-04-22 |
| Find all providers in zip 50314 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486776 | Innovative Radiology LLC | Radiology | 13409 Douglas Pkwy, Des Moines, IA 50323-2400 | 2020-10-29 |
| 1174148548 | Aaron Patrick Cronican | Radiology | 1801 Hickman Rd, Des Moines, IA 50314-1597 | 2020-06-11 |
| 1457973158 | Donald Zhang | Radiology | 1801 Hickman Rd, Des Moines, IA 50314-1548 | 2020-05-15 |
| 1457918419 | Jamie L Strike | Radiology | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2019-05-24 |
| 1780177857 | Travis James Merritt | Radiology | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2018-06-12 |
| 1497247159 | Thomas P Lo Duca | Radiology | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2018-05-30 |
| 1598256703 | John A Burt | Radiology | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2018-05-23 |
| 1487183893 | Alyssa Kate Plouzek | Radiology | 1801 Hickman Road, Des Moines, IA 50314 | 2017-06-08 |
| 1477080398 | Joshua Douglas States | Radiology | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2017-05-23 |
| 1487004529 | Tyler Andrew Smith | Radiology | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2016-06-20 |
| Find all providers in DES MOINES | ||||
| City | DES MOINES |
| Zip Code | 50314 |
Please comment or provide details below to improve the information on DR. THOMAS A. MALLISEE III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.