Healthcare Provider Details

I. General information

NPI: 1649777947
Provider Name (Legal Business Name): JANE JURMA STEPHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 GORDON RD SUITE 103
JASPER GA
30143
US

IV. Provider business mailing address

49 GORDON RD
JASPER GA
30143-1017
US

V. Phone/Fax

Practice location:
  • Phone: 706-692-9768
  • Fax: 706-692-4040
Mailing address:
  • Phone: 706-692-9768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number98079
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: