Provider Demographics
NPI:1083914048
Name:JODI VAN JURA MD, INC
Entity Type:Organization
Organization Name:JODI VAN JURA MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN JURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-821-3700
Mailing Address - Street 1:1507 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1437
Mailing Address - Country:US
Mailing Address - Phone:513-821-3700
Mailing Address - Fax:513-821-4333
Practice Address - Street 1:1507 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1437
Practice Address - Country:US
Practice Address - Phone:513-821-3700
Practice Address - Fax:513-821-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty