Healthcare Provider Details

I. General information

NPI: 1386135648
Provider Name (Legal Business Name): TATIANA CORREA MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-2201
  • Fax: 319-356-3949
Mailing address:
  • Phone: 319-356-2201
  • Fax: 319-356-3949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA201875
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD-57691
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD-57691
License Number StateIA
# 4
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberMD-57691
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD-57691
License Number StateIA
# 6
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License NumberMD-57691
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: