Individual
DR. JODI LYNNE VAN JURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4000 MIAMISBURG CENTERVILLE RD, SUITE 410, MIAMISBURG, OH 45342-7615
(937) 384-8773
(937) 384-0794
Mailing address
4000 MIAMISBURG CENTERVILLE RD STE 410, MIAMISBURG, OH 45342-3758
(937) 384-8773
(937) 384-0794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.079730
OH
207QA0505X
Adult Medicine Physician
35079730
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2350950
—
OH
Enumeration date
08/18/2006
Last updated
11/16/2022
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