Dr. Jim Paul Licandro is a Long Grove, Iowa based podiatrist who is specialized in Podiatry. Active license number of Dr. Jim Paul Licandro for Podiatry is 00705 in Iowa.
Dr. Jim Paul Licandro is qualified with a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. He diagnose and treat foot diseases and deformities. He can perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Complete Profile:
Dr. Jim Paul Licandro speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Specialization: | Podiatry |
| Credentials: | DPM |
| Gender: | Male |
| Practice Address: | 405 Woodlawn Rd, Long Grove,
Iowa, 52756 |
| Phone: | 832-425-7457 |
| Fax: | 563-285-5446 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1609873538 |
| NPI Enumeration Date: | 07 Jul, 2005 |
| NPI Last Update On: | 22 Jul, 2018 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Jim Paul Licandro are as mentioned below.
| License Number | Specialization | State | Status | |
| 00705 | Podiatry | Iowa | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Jim Paul Licandro such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1197210 | Medicaid | Iowa | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 5261 Boulder Dr Apt D,
West Des Moines, Iowa |
| Zip: | 50265-7823 |
| Phone Number: | 563-340-4387 |
| Fax Number: | 563-424-7234 |
Patients can reach Dr. Jim Paul Licandro at
405 Woodlawn Rd, Long Grove, Iowa or can
call to book an appointment on 832-425-7457.
Comments/ Reviews:
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** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.