Organization
RIVER CITIES INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS J JERGENSON MD (PRESIDENT)
(563) 242-7522
Entity
Organization
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
363A00000X
Physician Assistant
00961
IA
363L00000X
Nurse Practitioner
A-077904
IA
363L00000X
Nurse Practitioner
A-080599
IA
Other
Enumeration date
06/10/2005
Last updated
10/28/2008
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