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General NPI Number Information
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NPI Number | 1497634810
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Entity Type | Individual
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Provider Name | JAKUB YOUNGSTROM
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Gender | Male
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 101 JESSUP HALL
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City | IOWA CITY
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State | IA
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Zip | 52242-1316
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Country | US
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Telephone | 319-335-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1146 PARK CT
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City | HASTINGS
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State | MN
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Zip | 55033-2548
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number | NA
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License Number State | IA
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