Individual
JEROME W JANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6911 C AVE NE, CEDAR RAPIDS, IA 52402-1349
(319) 832-1463
(319) 832-4469
Mailing address
6911 C AVE NE, CEDAR RAPIDS, IA 52402-1349
(319) 832-1463
(319) 832-4469
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02966
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080080079
RR MEDICARE
IA
01
—
0801168212
RR MEDICARE
IA
05
—
1128744
—
IA
05
—
1144208752
—
IA
05
—
2128744
—
IA
Enumeration date
01/04/2006
Last updated
05/17/2012
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