Individual
DR. AMY M DEJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
120 W MAIN ST, VERMILLION, SD 57069-3036
(605) 624-4291
(604) 624-6822
Mailing address
120 W MAIN ST, VERMILLION, SD 57069-3036
(605) 624-4291
(604) 624-6822
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
02198
IA
152W00000X
Optometrist
Primary
578
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11321
AVERA HEALTH PLANS
SD
01
—
200648368
TRICARE/TRIWEST PROVIDER
SD
01
—
2203601
MEDICA UNITEDHEALTHCARE
SD
01
—
238521
MIDLANDS CHOICE, AETNA, CIGNA
SD
01
—
32866
SANFORD HEALTH PLAN
SD
01
—
399493
COVENTRY HEALTH CARE OF IOWA
—
01
—
4995791
BLUE SHIELD PROVIDER
SD
01
—
578
DAKOTACARE PIN
SD
01
—
6056244291
VISION SERVICE PLAN
SD
05
—
9200863
—
SD
01
—
9219420
DAKOTACARE GROUP NUMBER
SD
01
—
I3186
SANFORD PIN
SD
01
—
OP2175
EYEMED
SD
Enumeration date
01/17/2006
Last updated
02/27/2015
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