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NPI Code Detail

MEDICARE: NEXUS WOUND CONSULTANTS PC

MEDICARE: NEXUS WOUND CONSULTANTS PC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1225875313
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEXUS WOUND CONSULTANTS PC
Provider Business Mailing Address
First Line : 372 S EAGLE RD
Second Line :
City : EAGLE
State : ID
Zip : 83616-5908
Country : US
Telephone Number : 830-282-8224
Fax Number : 830-215-4711
Provider Business Practice Location Address
First Line : 330 N BRAND BLVD STE 700
Second Line :
City : GLENDALE
State : CA
Zip : 91203-2336
Country : US
Telephone Number : 830-285-8882
Fax Number : 830-215-4711
Authorized Official
Title or Position : CEO
Name : DR. SAMUEL JAMES JURCA
Credential : DO
Telephone Number : 830-282-8224
Provider Enumeration Date : 07/15/2024
Last Update Date : 06/23/2026

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Directions to “NEXUS WOUND CONSULTANTS PC ” Practice Location

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