Individual
DR. JASON MICHAEL DIERKING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 E 5TH ST, STORM LAKE, IA 50588-2342
(712) 213-4750
(712) 213-5230
Mailing address
1525 W 5TH ST, STORM LAKE, IA 50588-3027
(712) 213-4750
(712) 213-5230
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
37099
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0786335
—
IA
Enumeration date
04/04/2007
Last updated
10/16/2019
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