MEDICARE: DEBBIE MARY JURGELSKY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	017289	LA
2	207V00000X	Obstetrics & Gynecology Physician	017289	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07-00176	OTHER	LA	UNITED HEALTH CARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215936976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBIE MARY JURGELSKY M.D.

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	337-470-2605
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	4600 AMBASSADOR CAFFERY PKWY
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6902
Country	:	US
Telephone Number	:	337-470-2605
Fax Number	:	337-470-4595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	07/24/2025

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