Provider Demographics
NPI:1881126852
Name:WUNDERLICH, JEFFREY RHODUS JR
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:RHODUS
Last Name:WUNDERLICH
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 A AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5074
Mailing Address - Country:US
Mailing Address - Phone:319-369-7909
Mailing Address - Fax:319-368-7737
Practice Address - Street 1:1026 A AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5074
Practice Address - Country:US
Practice Address - Phone:319-369-7909
Practice Address - Fax:319-368-7737
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-501122084H0002X, 2084A0401X, 207R00000X, 2084P0800X
PAMD484220207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No2084H0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyHospice and Palliative Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAMD-50112OtherLICENSE