Individual
JEROLD CLANCY ERLANDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38515
IA
207R00000X
Internal Medicine Physician
R-7904
IA
207RN0300X
Nephrology Physician
Primary
38515
IA
208M00000X
Hospitalist Physician
38515
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00606
—
IA
01
—
P01025432
RR MEDICARE
IA
Enumeration date
05/22/2007
Last updated
10/31/2014
Update your record
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