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Individual

JORGE F SOTOLONGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
201 RIDGE ST, #307, COUNCIL BLUFFS, IA 51503-4643
(712) 329-5700
(712) 329-5759
Mailing address
201 RIDGE ST, #307, COUNCIL BLUFFS, IA 51503-4643
(712) 329-5700
(712) 329-5759

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
18305
NE
207V00000X
Obstetrics & Gynecology Physician
Primary
27364
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06287
WELLMARK-ATLANTIC
05
10025407200
NE
01
20108
BCBSN
01
22905
WELLMARK-201 RIDGE
05
3060582
IA
05
3171538
IA
05
4171538
IA
05
42150546516
NE
05
42150546517
NE
05
42150546518
NE
05
42150546520
NE
05
5171538
IA
05
7171538
IA
05
8171538
IA
01
97474
WELLMARK-LAKESIDE
01
97475
WELLMARK-S. 24TH
01
97476
WELLMARK-CENTER
Enumeration date
08/31/2006
Last updated
07/09/2007
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