# JAMESON ORTHOPEDIC CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154375731
- **Authorized official:** THERON QUENTIN JAMESON D.O. (PRESIDENT AND CEO)
- **Authorized official phone:** (319) 752-4553

## Contact information

- **Practice address:** 1225 S GEAR AVE, SUITE 159, WEST BURLINGTON, IA 52655-1691
- **Practice address phone:** (319) 752-4553
- **Practice address fax:** (319) 753-0462
- **Mailing address:** 2213 GRAND AVE, DES MOINES, IA 50312-5305
- **Mailing address phone:** (515) 237-3974
- **Mailing address fax:** (515) 883-2692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | IA | Yes |
| 363A00000X | Physician Assistant | — | IA | — |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 10/19/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0462325 | — | IA |