Dierking, Jason Michael

Dierking, Jason Michael is an sole proprietor health care provider with primary practice located at 210 E 5Th St , Storm Lake IA 50588-2342. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Dierking, Jason Michael can be contacted via phone (712) 213-4750.

Contact Information

Primary practice address
210 E 5Th St Storm Lake IA 50588-2342
Phone: (712) 213-4750
Fax: (712) 213-5230
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 37099 Iowa

Profile Details

NPI number 1477675940
LBN Legal business name Dierking, Jason Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2007
Last updated Oct 16th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477675940 NPPES
Iowa MEDICAID 0786335

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