MEDICARE: DR. CHRISTOPHER WARD JUERGENS MD

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	208600000X	Surgery Physician	35.068899	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225026412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER WARD JUERGENS MD

Provider Business Mailing Address
First Line	:	3050 MACK RD
Second Line	:	STE 310
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5376
Country	:	US
Telephone Number	:	513-924-8895
Fax Number	:

Provider Business Practice Location Address
First Line	:	2960 MACK RD
Second Line	:	STE. 205
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5373
Country	:	US
Telephone Number	:	513-924-8895
Fax Number	:	513-924-8910

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	04/14/2020

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