Organization
CJ ELMWOOD PARTNERS L P
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES E JONES M.D. (MEDICAL DIRECTOR)
(712) 239-3937
Entity
Organization
Contact information
Practice address
4405 HAMILTON BLVD, SIOUX CITY, IA 51104-1140
(712) 239-3937
(712) 239-4946
Mailing address
4405 HAMILTON BLVD, SIOUX CITY, IA 51104-1140
(712) 239-3937
(712) 239-4946
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
NOT APPLICABLE
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0610188
—
IA
05
—
351713600
—
MN
05
—
5490075
—
SD
Enumeration date
12/28/2005
Last updated
03/14/2023
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