Jerome D. Poland MD LTD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

2807770001 Issued in MN

Legal business name

JEROME D. POLAND MD LTD

Doing business as

dba Crosby Eye Clinic

Practice address

1 3Rd Ave NE
Crosby, MN 56441-1665

Phone

(218) 546-5108

Fax

(218) 546-5736

NPI assigned

May 15, 2006

Last updated

Jun 30, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jerome D. Poland, M.D.

Title

President

Phone

(218) 546-5108

Specialties & licenses 1

Addresses

Other names 1

• dba Crosby Eye Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1780635664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 3RD AVE NE",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411665",
            "telephone_number": "218-546-5108",
            "fax_number": "218-546-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 3RD AVE NE",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411665",
            "telephone_number": "218-546-5108",
            "fax_number": "218-546-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME D. POLAND MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "POLAND",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-546-5108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": "2807770001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Crosby Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paige Elizabeth Holmgren, MD
• Joshua M Horowitz, DO
• Matthew Wayne Houge, CRNA
• Amber Hubbling, PHARMD
• Elisabeth S Jenkins, PA-C
• Wendi A Johnson, MD
• Paige Ashley Kane, PA-C
• Evan Kelly, MD
• Leah Rachel Kippes, MD
• Jeffrey F Klassen, MD

• Eyewear Supplier in Crosby, MN
• Providers in Crosby, MN by specialty
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.