Organization
JOHN D. KIERNAN OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D. KIERNAN O.D. (OWNER)
(712) 252-4406
Entity
Organization
Contact information
Practice address
1214 PIERCE ST, SIOUX CITY, IA 51105-1417
(712) 252-4406
(712) 252-5296
Mailing address
1214 PIERCE ST, SIOUX CITY, IA 51105-1417
(712) 252-4406
(712) 252-5296
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1687
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0264600001
DME
IA
01
—
17801
MEDICARE
IA
Enumeration date
02/20/2008
Last updated
04/09/2008
Update your record
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