Individual
DR. CHESTER PENN DE JONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
803 S GREENE ST, ROCK RAPIDS, IA 51246-1948
(712) 472-3716
(712) 472-2878
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28191
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0250498
—
IA
05
—
0638700
—
IA
05
—
1075648
—
IA
05
—
4075648
—
IA
Enumeration date
10/23/2006
Last updated
12/15/2021
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