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Individual

STEVEN J JUDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1125 MADISON ST, JEFFERSON CTY, MO 65101-5227
(573) 632-5436
Mailing address
PO BOX 633819, CINCINNATI, OH 45263-0001
(865) 292-3000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
31777
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000848449A
GA
05
000848449B
GA
05
009913050
AL
05
009941583
AL
05
203290838
MO
01
3126986
BLUE CROSS
TN
01
3126988
BLUE CROSS
TN
05
3845255
TN
05
3845256
TN
01
P00233188
RAILROAD MEDICARE
MO
01
P00269092
RAILROAD MEDICARE
TN
Enumeration date
06/08/2006
Last updated
11/20/2007
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