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Organization

JEROME D. POLAND, M.D., LTD

Active
Parent organization
JEROME D. POLAND, M.D., LTD
Other names
Crosby Eye Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
JEROME D. POLAND, M.D., LTD
Authorized official
KARIN M COOK (OFFICE MANAGER)
(218) 546-5108
Entity
Organization

Contact information

Practice address
200 ELM ST N, ONAMIA, MN 56359-7901
(320) 532-3154
(320) 532-3111
Mailing address
1 3RD AVE NE, CROSBY, MN 56441-1665
(218) 546-5108
(218) 546-5736

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
566R0CR
BLUE PLUS DISP
MN
01
85038PO
BLUE CROSS/BLUE SHIELD MN
MN
01
CG9827
PALMETTO GBA
MN
Enumeration date
10/24/2007
Last updated
04/04/2008
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