Jergenson, Douglas J
Jergenson, Douglas J is an individual health care provider with primary practice located at 221 Main Ave , Clinton IA 52732-2241. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Jergenson, Douglas J can be contacted via phone (563) 242-7522.Contact Information
Primary practice address
221 Main Ave
Clinton IA 52732-2241
Phone: (563) 242-7522
Fax: (563) 242-7534
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 22254 | Iowa |
Profile Details
| NPI number | 1689678344 |
|---|---|
| LBN Legal business name | Jergenson, Douglas J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Oct 13th, 2007 - about 19 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 | 1689678344 | NPPES |
| Iowa | MEDICAID | 1193565 |
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