Individual
DR. KENNETH A JURIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2720 NORTH UNIVERSITY DRIVE, NACOGDOCHES, TX 75965
(936) 205-9824
Mailing address
2720 NORTH UNIVERSITY DRIVE, NACOGDOCHES, TX 75965
(936) 205-9824
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
P4325
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1910708
—
MI
Enumeration date
11/04/2005
Last updated
06/04/2013
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