Paul Brian Juergens, M.D.
Individual provider Active NPI Pain Medicine Physician · Du Quoin, IL
NPI 1922026673 · NPPES record last updated Jan 19, 2016
Key facts
- NPI
- 1922026673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pain Medicine Physician 208VP0000X
- License
- 036067084 (IL)
- Practice address
- 900 N Washington St
Du Quoin, IL 62832-1233 - Phone
- (573) 575-6440
- Fax
- (618) 942-7399
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Illinois Pain Management | Past |
Accepting new patients | |
| Advanced Spine & Joint | Past | Accepting new patients |
Interoperability endpoints
- paul.juergens@mbhdq.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | 036067084 | IL | Yes |
Addresses
Primary practice location
900 N Washington St
Du Quoin, IL 62832-1233
Mailing address
PO Box 3441
Carbondale, IL 62902-3441
Phone (573) 575-6440
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0010022254 | Other | IL | BLUE CROSS BLUE SHIELD |
| CH1495 | Other | IL | RAILROAD MEDICARE |
| 036067084 | Medicaid | IL |
Other providers in Du Quoin, IL
- Jamestown Manor Inc
- Jamestown Manor Inc
- Roger C. Jenkins
- John W. Melvin DC LTD
- Chad R. Johnston
- Beth Keith-Mudgette
- Kidney Care Services of Southern Illinois, LTD
- Kims Family Healthcare LLC
- Danielle Klump
- Alisha Kosma
All providers in Du Quoin, IL · Pain Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.