Healthcare Provider Details

I. General information

NPI: 1952409336
Provider Name (Legal Business Name): JEFFERSON COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S MAIN ST
FAIRFIELD IA
52556-9572
US

IV. Provider business mailing address

2000 S MAIN ST
FAIRFIELD IA
52556-9572
US

V. Phone/Fax

Practice location:
  • Phone: 641-472-4111
  • Fax: 641-469-4375
Mailing address:
  • Phone: 641-472-4111
  • Fax: 641-469-4375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number510063H
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number03066
License Number StateIA

VIII. Authorized Official

Name: BRENT ROBERT FEICKERT
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 641-469-4304