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Individual

DR. JASON J DEUTMEYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4480 UTICA RIDGE RD, SUITE 1124, BETTENDORF, IA 52722-1656
(563) 742-5300
(563) 742-5305
Mailing address
4480 UTICA RIDGE ROAD, SUITE 1124, BETTENDORF, IA 52722-1626
(563) 742-5300
(563) 742-5305

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036104564
IL
208600000X
Surgery Physician
Primary
34035
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036104564
IA
05
1104899095
IA
05
1240812
IA
01
38078
BCWELLMARK
01
IA01X2
JOHN DEERE
01
P01205760
RR MEDICARE
IA
Enumeration date
02/10/2006
Last updated
02/05/2015
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