Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD042702L | PA |
NPI | 1124092432 |
---|---|
Provider Name | Rodney J Landreneau |
First Address | Kittanning, PA 16201-7110 |
Second Address | Kittanning, PA 16201-7110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 12/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001219160 | (05) | PA |
00821731 | (05) | MS |
0968118 | (05) | OH |
2336371 | (05) | LA |
A13026 | (02) | PA |