Carol L Juergens (NPI# 1174591325, PAC ID# 8325946569) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1174591325 |
| PAC ID by PECOS | 8325946569 |
| Professional Enrollment ID | I20100128000556 |
| Full Name | Carol L Juergens |
| Organization Legal Name | KODIAK ISLAND MEDICAL ASSOCIATES |
| Address |
1818 E Rezanof Dr Kodiak AK 99615-6505 |
| Phone Number | 9074866065 |
| Gender | F |
| Medical School | MAYO MEDICAL SCHOOL |
| Graduation Year | 1976 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 5799677761 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 021306 | PROVIDENCE KODIAK ISLAND MEDICAL CTR |
| 020001 | PROVIDENCE ALASKA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1818 E Rezanof Dr, Kodiak, AK 99615-6505 | 9074866065 | KODIAK ISLAND MEDICAL ASSOCIATES |
| Organization Legal Name | KODIAK ISLAND MEDICAL ASSOCIATES |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rae Jean Blaschka | Nurse Practitioner | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Mark E Withrow | General Practice | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Street Address |
1818 E REZANOF DR |
| City | KODIAK |
| State | AK |
| Zip | 99615-6505 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rae Jean Blaschka | Nurse Practitioner | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Mark E Withrow | General Practice | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jerimiah L Myers | Optometry | 214 W Rezanof Dr, Suite 1, Kodiak, AK 99615-6044 | |
| Kevin Creelman | General Practice | 104 Ctr Ave, Suite 100, Kodiak, AK 99615-6393 | |
| John M Weaver | Clinical Social Worker | Providence Health and Services Washington | 717 E Rezanof Dr, Kodiak, AK 99615-6416 |
| Welby N Jensen | Psychiatry | Providence Health and Services Washington | 717 E Rezanof Dr, Kodiak, AK 99615-6416 |
| Laura M Creighton | Chiropractic | 814 E Rezanof Dr, Kodiak, AK 99615-6599 | |
| Janet Abadir | General Surgery | Providence Health and Services Washington | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Melissa K Witteveen | Physician Assistant | Kodiak Island Healthcare Foundation | 1911 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Stephen S Burnside | Internal Medicine | Providence Health and Services Washington | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Wendell H Wilmoth | Diagnostic Radiology | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 | |
| Jenna N Walker | Nurse Practitioner | Kodiak Island Healthcare Foundation | 1911 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Find all physicians in zip 99615 | |||
| City | KODIAK |
| Zip Code | 99615 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | KODIAK + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Carol L Juergens.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.