MEDICARE: JEROME PIERSON MD

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
1	207RC0000X	Cardiovascular Disease Physician	25565	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659345668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEROME PIERSON MD

Provider Business Mailing Address
First Line	:	PO BOX 3128
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51102-3128
Country	:	US
Telephone Number	:	712-239-4702
Fax Number	:	712-239-0616

Provider Business Practice Location Address
First Line	:	801 5TH ST
Second Line	:	STE 410
City	:	SIOUX CITY
State	:	IA
Zip	:	51102-1394
Country	:	US
Telephone Number	:	712-239-4702
Fax Number	:	712-239-0616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/18/2007

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Directions to “ JEROME PIERSON MD” Practice Location

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