Individual
JUSTIN K SHURTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
56108
WI
208M00000X
Hospitalist Physician
56108-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
125055393
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125055393
STATE LICENSE
IL
Enumeration date
07/08/2008
Last updated
09/10/2015
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