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General NPI Number Information
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NPI Number | 1669650826
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Entity Type | Individual
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Provider Name | JEREMY SCOTT JUERN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 2 MEDICAL PLAZA DR SUITE 275
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City | ROSEVILLE
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State | CA
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Zip | 95661-3043
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Country | US
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Telephone | 414-805-8622
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Fax | 414-805-8641
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Provider Business Mailing Address
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Address Line | 9200 W WISCONSIN AVE TRAUMA AND CRITICAL CARE SURGERY
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City | MILWAUKEE
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State | WI
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Zip | 53226-3522
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Country | US
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Telephone | 414-805-8622
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Fax | 414-805-8641
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 53207-020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | C153801
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License Number State | CA
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