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NPI Code Detail

MEDICARE: RIVER CITIES INTERNAL MEDICINE PC

MEDICARE: RIVER CITIES INTERNAL MEDICINE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerA-080599IA
2363A00000XPhysician Assistant00961IA
3363L00000XNurse PractitionerA-077904IA
4207R00000XInternal Medicine Physician22254IA

General Provider Information

NPI Number : 1922002591
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER CITIES INTERNAL MEDICINE PC
Provider Business Mailing Address
First Line : 221 MAIN AVE
Second Line :
City : CLINTON
State : IA
Zip : 52732-2241
Country : US
Telephone Number : 563-242-7522
Fax Number : 563-242-7534
Provider Business Practice Location Address
First Line : 221 MAIN AVE
Second Line :
City : CLINTON
State : IA
Zip : 52732-2241
Country : US
Telephone Number : 563-242-7522
Fax Number : 563-242-7534
Authorized Official
Title or Position : PRESIDENT
Name : DOUGLAS J JERGENSON
Credential : MD
Telephone Number : 563-242-7522
Provider Enumeration Date : 06/10/2005
Last Update Date : 10/28/2008

Similar Medicare Providers

1689678344 — DOUGLAS J JERGENSON MD
Practice Location Address:
221 MAIN AVE
CLINTON, IA
52732-2241
Practice Phone: 563-242-7522
Practice Fax: 563-242-7534
1114921772 — KELLY J JERGENSON ARNP
Practice Location Address:
221 MAIN AVE
CLINTON, IA
52732-2241
Practice Phone: 563-242-7522
Practice Fax: 563-242-7534
1942294483 — DR. ERIN KIMBERLY HERNDON M.D.
Practice Location Address:
221 MAIN AVE
CLINTON, IA
52732-2241
Practice Phone: 563-242-7522
Practice Fax: 563-242-7534
1710995758 — CLINTON MEDICAL CLINIC PHARMACY INC
Practice Location Address:
221 MAIN AVE
CLINTON, IA
52732-2241
Practice Phone: 563-242-1724
Practice Fax: 563-243-8435
1013160761 — DOROTHY JEAN ANDERSON ARNP
Practice Location Address:
221 MAIN AVE
CLINTON, IA
52732-2241
Practice Phone: 563-242-7522
Practice Fax: 563-242-7534
1962750422 — AMANDA S DALASKA ARNP
Practice Location Address:
221 MAIN AVE
CLINTON, IA
52732-2241
Practice Phone: 563-242-7522
Practice Fax: 563-242-7534

Directions to “RIVER CITIES INTERNAL MEDICINE PC ” Practice Location

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