Individual
JEFFREY JAY FAGERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
330 LAUREL ST STE 1100, DES MOINES, IA 50314-3044
(515) 288-3287
Mailing address
330 LAUREL ST STE 1100, DES MOINES, IA 50314-3044
(515) 288-3287
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02469
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2102251
—
IA
Enumeration date
09/20/2006
Last updated
07/08/2007
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