Healthcare Provider Details
I. General information
NPI: 1336106301
Provider Name (Legal Business Name): JOHN H. JURIGE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 12/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 HOSPITAL BLVD
JEFFERSONVILLE IN
47130-3769
US
IV. Provider business mailing address
101 HOSPITAL BLVD
JEFFERSONVILLE IN
47130-3769
US
V. Phone/Fax
- Phone: 812-282-3899
- Fax: 812-282-4172
- Phone: 812-282-3899
- Fax: 812-282-4172
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | 24059 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | 01039534A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: