Jerone Theodore Landstrom
Surgeon Surgery of the Hand
633 Gov Carlos Camacho Road Suite 104 Guam Medical Plaza
Tamuning
, Guam 96913
Jerone Theodore Landstrom
Surgeon Surgery of the Hand
633 Gov Carlos Camacho Road Suite 104 Guam Medical Plaza
Tamuning
, Guam 96913
(671) 649-2266
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About
Features
Specialties
- Surgeon
- Surgery of the Hand
Languages spoken
- English
Location
First Address
- Jerone Theodore Landstrom
- 633 Gov Carlos G Camacho Rd Ste 212
- Tamuning, GU
- Zip : 96913-3195
- Fax : (671) 649-2266
- Phone : (671) 646-4263
Second Address
- Jerone Theodore Landstrom
- 633 Gov Carlos Camacho Road Suite 104 Guam Medical Plaza
- Tamuning, GU
- Zip : 96913
- Fax : (671) 649-1019
- Phone : (671) 646-4263
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FAQs
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Is Jerone Theodore Landstrom a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | M-958 | GU |
| N | 208600000X | Surgeon | M-958 | GU |
| N | 2086S0105X | Surgery of the Hand | J9150 | TX |
| Y | 2086S0105X | Surgery of the Hand | M00958 | GU |
| N | 2086S0105X | Surgery of the Hand | MD9588 | HI |
National Provider Identifier
| NPI | 1255407953 |
|---|---|
| Provider Name | Jerone Theodore Landstrom |
| First Address | Tamuning, GU 96913-3195 |
| Second Address | Tamuning, GU 96913 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/11/2006 |
| Last Update Date | 27/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0005867019 | AETNA (01) | |
| 170804300 | USDOL (01) | |
| F05541 | (02) | |
| J6266501 | (05) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.