Individual
CAROL JUERGENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1818 E REZANOF DR, KODIAK, AK 99615
(907) 486-6065
(907) 486-2248
Mailing address
PO BOX 8689, KODIAK, AK 99615-8689
(907) 486-6065
(907) 486-2248
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
AA1786
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0173
—
AK
05
—
MD1786
—
AK
Enumeration date
03/14/2006
Last updated
12/06/2017
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