MEDICARE: RHONDA JO SOWARDS MD

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	207P00000X	Emergency Medicine Physician	36437	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00616056	OTHER	IA	RR MEDICARE
2	P00411063	OTHER	IA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	01071	OTHER	IA	WELLMARK BCBS
4	36437	OTHER	IA	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1326062621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA JO SOWARDS MD

Provider Business Mailing Address
First Line	:	1807 1ST ST
Second Line	:
City	:	COAL VALLEY
State	:	IL
Zip	:	61240-9347
Country	:	US
Telephone Number	:	309-256-8597
Fax Number	:

Provider Business Practice Location Address
First Line	:	1807 1ST ST
Second Line	:
City	:	COAL VALLEY
State	:	IL
Zip	:	61240-9347
Country	:	US
Telephone Number	:	309-256-8597
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	10/03/2008

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