Gottula, Roderic Dean
Gottula, Roderic Dean is an sole proprietor health care provider with primary practice located at 800 Kenyon Rd Ste Q , Fort Dodge IA 50501-5776. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gottula, Roderic Dean can be contacted via phone (515) 574-8519.Contact Information
Primary practice address
800 Kenyon Rd Ste Q
Fort Dodge IA 50501-5776
Phone: (515) 574-8519
Fax: (515) 574-8514
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 29988 | Colorado |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 44546 | Iowa |
Profile Details
| NPI number | 1588789150 |
|---|---|
| LBN Legal business name | Gottula, Roderic Dean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 20th, 2007 |
| Last updated | Jul 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588789150 | NPPES |
| Colorado | Other | 29988 | STATE LICENSE |
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