Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35481 | IA |
Y | 208600000X | Surgeon | 35481 | IA |
NPI | 1023004017 |
---|---|
Provider Name | Dr. Rene Recinos |
First Address | Mason City, IA 50401-2926 |
Second Address | Mason City, IA 50401-2926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 06/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
434795 | (05) | IA |
I03340 | (02) | IA |