Healthcare Provider Details

I. General information

NPI: 1457663213
Provider Name (Legal Business Name): JORDAN MATHEW JURGENS I M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SW 10TH AVE
TOPEKA KS
66604-1353
US

IV. Provider business mailing address

1500 SW 10TH AVE
TOPEKA KS
66604-1353
US

V. Phone/Fax

Practice location:
  • Phone: 785-354-6000
  • Fax:
Mailing address:
  • Phone: 785-354-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number04-40034
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2010018494
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: