Provider Demographics
NPI:1356653521
Name:BORKOVEC, REBECCA ERIN (OD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ERIN
Last Name:BORKOVEC
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:ERIN
Other - Last Name:ASPHOLM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:640 HIGHWAY 1 W
Mailing Address - Street 2:SUITE 2
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4218
Mailing Address - Country:US
Mailing Address - Phone:319-338-6700
Mailing Address - Fax:
Practice Address - Street 1:640 HIGHWAY 1 W
Practice Address - Street 2:SUITE 2
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4218
Practice Address - Country:US
Practice Address - Phone:319-338-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002486152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IB18930002Medicare PIN