MEDICARE: IRA H. REX III, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	76995	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1300065	OTHER	MA	UNITED HEALTH CARE
2	797314	OTHER	MA	TUFTS HEALTH PLAN
3	204281	OTHER	RI	BLUE CHIP
4	M17366	OTHER	MA	BCBS OF MA (GROUP)
5	0019396	OTHER	MA	NEIGHBORHOOD HEALTH
6	21215	OTHER	MA	HARVARD PILGRIM HEALTH
7	4833-8	OTHER	RI	BCBS OF RI
8	J13304	OTHER	MA	BCBS OF MA (INDIVIDUAL)

General Provider Information

NPI Number	:	1225193477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRA H. REX III, M.D., P.C.

Provider Business Mailing Address
First Line	:	10 N MAIN ST
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-2130
Country	:	US
Telephone Number	:	508-674-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 N MAIN ST
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-2130
Country	:	US
Telephone Number	:	508-674-6100
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ROBIN FIELDING-REX
Credential	:
Telephone Number	:	508-674-6100

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	10/05/2007

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