Provider Demographics
NPI:1376582205
Name:JAMIESON, KATARZYNA J (MD)
Entity Type:Individual
Prefix:DR
First Name:KATARZYNA
Middle Name:J
Last Name:JAMIESON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATARZYNA
Other - Middle Name:J
Other - Last Name:JAMIESON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-2038
Mailing Address - Fax:319-353-8383
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-2038
Practice Address - Fax:319-353-8383
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79389207RH0003X
IA38123207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258028400Medicaid
FL258028400Medicaid
FL49501ZMedicare PIN
IAP00701725Medicare PIN
FL49501Medicare ID - Type Unspecified
IAI09230001Medicare PIN