Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD-19793 | IA |
N | 2086S0127X | Trauma Surgeon | 19793 | IA |
N | 2086S0129X | Vascular Surgeon | 19793 | IA |
NPI | 1063404986 |
---|---|
Provider Name | Timothy A Thomsen |
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 | 17/08/2005 |
Last Update Date | 08/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1189019 | (05) | IA |
36493 | WELLMARK BCBS (01) | IA |
A01893 | (02) |