Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | MD44845 | IA |
N | 207RP1001X | Pulmonary Disease | MD44845 | IA |
N | 2080P0214X | Pediatric Pulmonologist | MD44845 | IA |
NPI | 1023154242 |
---|---|
Provider Name | Dr. Robert Jesse Blount |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 09/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
818304 | (05) | AZ |
H98350 | (02) | AZ |