Individual
JOHN JERSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 W 69TH ST, SIOUX FALLS, SD 57108-8148
(307) 635-5393
(307) 635-2199
Mailing address
PO BOX 20190, CHEYENNE, WY 82003-7004
(307) 635-5393
(307) 635-2199
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3448
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007856
WELLMARK
SD
01
—
3448
DAKOTA CARE
SD
05
—
6003932
—
SD
Enumeration date
07/27/2006
Last updated
07/08/2007
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