Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 36568 | IA |
NPI | 1447292800 |
---|---|
Provider Name | Dr. Jeremy D Vos |
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 | 11/06/2006 |
Last Update Date | 29/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0423459 | (05) | IA |
15932 | WELLMARK (01) | |
493486 | (05) | IA |
I 55179 | (02) | IA |