MEDICARE: JOHN W JADERLUND MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	G5207	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932195468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN W JADERLUND MD

Provider Business Mailing Address
First Line	:	2401 W OAK ST STE 102
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-2381
Country	:	US
Telephone Number	:	940-387-2241
Fax Number	:	940-380-1374

Provider Business Practice Location Address
First Line	:	2401 W OAK ST STE 102
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-2381
Country	:	US
Telephone Number	:	940-387-2241
Fax Number	:	940-380-1374

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	10/26/2020

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