Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 36365 | IA |
N | 208600000X | Surgeon | 36365 | IA |
Y | 2086X0206X | Surgical Oncologist | 36365 | IA |
NPI | 1265416705 |
---|---|
Provider Name | Ronald J Weigel |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 07/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0472811 | (05) | IA |
57847 | WELLMARK BCBS (01) | IA |
F34137 | (02) |