Organization
JAMESON ORTHOPEDIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERON QUENTIN JAMESON D.O. (PRESIDENT AND CEO)
(319) 752-4553
Entity
Organization
Contact information
Practice address
1225 S GEAR AVE, SUITE 159, WEST BURLINGTON, IA 52655-1691
(319) 752-4553
(319) 753-0462
Mailing address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
IA
363A00000X
Physician Assistant
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0462325
—
IA
Enumeration date
05/19/2006
Last updated
10/19/2007
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