Juergens, Paul Brian

Juergens, Paul Brian is an sole proprietor health care provider with primary practice located at 900 N Washington St , Du Quoin IL 62832-1233. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Juergens, Paul Brian can be contacted via phone (573) 575-6440.

Contact Information

Primary practice address
900 N Washington St Du Quoin IL 62832-1233
Phone: (573) 575-6440
Fax: (618) 942-7399
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 036067084 Illinois

Profile Details

NPI number 1922026673
LBN Legal business name Juergens, Paul Brian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2006
Last updated Jan 19th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922026673 NPPES
Illinois Other 0010022254 BLUE CROSS BLUE SHIELD
Illinois Other CH1495 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036067084 BLUE CROSS BLUE SHIELD

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