Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 32351 | IA |
NPI | 1851346282 |
---|---|
Provider Name | Dr. Dwayne Thomas Capper |
First Address | Iowa City, IA 52245-9565 |
Second Address | Iowa City, IA 52245-9565 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 19/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0169920 | (05) | IA |
040012052 | RAILROAD MEDICARE (01) | IA |
0423459 | (05) | IA |
44007 | WELLMARK (01) | IA |
G55015 | (02) | IA |