Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 15087 | NE |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 15087 | NE |
NPI | 1295787257 |
---|---|
Provider Name | John R Windle |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68198-8102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 26/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
47078557520 | (05) | NE |
B67948 | (02) | NE |