Healthcare Provider Details

I. General information

NPI: 1215670328
Provider Name (Legal Business Name): JASMEEN KAUR GURON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 MEDICAL PARK DR
BRIDGEPORT WV
26330-9006
US

IV. Provider business mailing address

327 MEDICAL PARK DR
BRIDGEPORT WV
26330-9006
US

V. Phone/Fax

Practice location:
  • Phone: 681-342-1000
  • Fax:
Mailing address:
  • Phone: 681-342-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4939
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: