Provider Demographics
NPI:1376545772
Name:JUROW, JAMES (PHD, NP)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:JUROW
Suffix:
Gender:M
Credentials:PHD, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14488 W CORA LN
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-8302
Mailing Address - Country:US
Mailing Address - Phone:623-204-5323
Mailing Address - Fax:623-251-5793
Practice Address - Street 1:14488 W CORA LN
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-8302
Practice Address - Country:US
Practice Address - Phone:623-204-5323
Practice Address - Fax:623-204-5323
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ107786363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ503426OtherAHCCCS
AZ503426OtherAHCCCS
AZS96043Medicare UPIN