Provider Demographics
NPI:1467409383
Name:NIELSEN, JARED STEVEN (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:STEVEN
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:309 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2946
Mailing Address - Country:US
Mailing Address - Phone:641-754-6200
Mailing Address - Fax:641-754-6245
Practice Address - Street 1:6200 WESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7705
Practice Address - Country:US
Practice Address - Phone:515-223-8685
Practice Address - Fax:515-222-9895
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-113163207W00000X
IA37052207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00411911OtherRAILROAD MEDICARE
IA02343OtherWELLMARK PIN
IA0766956Medicaid
IA0766956Medicaid
IA02343OtherWELLMARK PIN