Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 31965 | IA |
NPI | 1003810649 |
---|---|
Provider Name | Owen M Mccarron |
First Address | Cedar Rapids, IA 52406-3080 |
Second Address | Cedar Rapids, IA 52403-1251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 19/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G49446 | (02) | IA |