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Contact Information

JAY D PETERSMA, OD
5501 NW 86TH ST
SUITE 500
JOHNSTON, IA50131-1816
 Phone: 515-270-0494
 Fax: 515-270-6463
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Corneal and Contact Management

152WC0802X 41 Optometry
Indicates primary specialty

NPI Profile & details for JAY D PETERSMA · (Male)

NPI Number 1326148933
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 09/24/2006
Last updated 01/11/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • IA License # 01861
  • IA Other 18665 MIDLANDS CHOICE
  • IA Other 26387 WELLMARK
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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