| Douglas J Recker | |
|
1475 Boyson Rd Hiawatha IA 52233-2339 | |
| (319) 393-4019 | |
| (319) 378-2924 |
| Full Name | Douglas J Recker |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1475 Boyson Rd, Hiawatha, Iowa |
| Authorized Official Name and Position | Douglas James Recker (OWNER DENTIST) |
| Authorized Official Contact | 3193934019 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas J Recker 1475 Boyson Road Hiawatha IA 52233-2339 Ph: (319) 393-4019 | Douglas J Recker 1475 Boyson Rd Hiawatha IA 52233-2339 Ph: (319) 393-4019 |
| NPI Number | 1043267883 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043267883 | NPI | - | NPPES |
| 0200759 | Other | MEDICAID GROUP | |
| 0083212 | Medicaid | IA | |
| 1123307 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7455 (Iowa) | Primary |
| 1223G0001X | Dentist - General Practice | 7638 (Iowa) | Secondary |
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