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Individual

JACOB MATTHEW WEASEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1415 WOODLAND AVE, SUITE 140, DES MOINES, IA 50309-3203
(515) 241-4078
(515) 241-4080
Mailing address
1415 WOODLAND AVE, SUITE 140, DES MOINES, IA 50309-3203
(515) 241-4078
(515) 241-4080

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R-9654
IA

Other

Enumeration date
05/15/2013
Last updated
05/15/2013
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