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General NPI Number Information
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NPI Number | 1740443712
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Entity Type | Organization
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Legal Business Name | THOMAS E JESSEN MD PC
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 300 N 4TH AVE E STE 140A
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City | NEWTON
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State | IA
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Zip | 50208-3122
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Country | US
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Telephone | 641-792-2380
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Fax | 641-792-6184
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Provider Business Mailing Address
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Address Line | 300 N 4TH AVE E STE 140A
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City | NEWTON
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State | IA
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Zip | 50208-3122
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Country | US
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Telephone | 641-792-2380
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Fax | 641-792-6184
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS EDGAR JESSEN
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Credential | MD
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Telephone | 641-792-2380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 17964
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License Number State | IA
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