Individual
DOUGLAS J JERGENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
221 MAIN AVE, CLINTON, IA 52732-2241
(563) 242-7522
(563) 242-7534
Mailing address
221 MAIN AVE, CLINTON, IA 52732-2241
(563) 242-7522
(563) 242-7534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22254
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1193565
—
IA
Enumeration date
06/10/2005
Last updated
10/13/2007
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