Individual
JACK ISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1394
(712) 279-2505
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28904
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050083667
RAILROAD MEDICARE
—
01
—
30111
BLUE CROSS BLUE SHIELD
IA
05
—
3090639
—
IA
Enumeration date
08/11/2005
Last updated
04/29/2008
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