Individual
CORY D JURGENSMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2825 STOCKYARD RD STE I-200, MISSOULA, MT 59808-1548
(406) 728-8420
Mailing address
PO BOX 1847, GILBERT, AZ 85299-1847
(480) 507-2961
(480) 507-2971
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
49022
AZ
207L00000X
Anesthesiology Physician
Primary
MED-PHYS-LIC-89802
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
906297
—
AZ
Enumeration date
05/11/2010
Last updated
03/07/2023
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