Individual
DR. MARK EUGENE JERGENS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
Mailing address
1865 TERRY LN, VICTOR, MT 59875-9697
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD8711
ID
Other
Enumeration date
06/10/2006
Last updated
07/08/2007
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