Lynn Leroy Juracek
Dermatologist Dermatopathologist Procedural Dermatology Pediatric Dermatologist and 1 more
14239 W Bell Rd Suite 101
Surprise
, Arizona 85374-2469
Lynn Leroy Juracek
Dermatologist Dermatopathologist Procedural Dermatology Pediatric Dermatologist and 1 more
14239 W Bell Rd Suite 101
Surprise
, Arizona 85374-2469
(623) 544-8665
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About
Features
Specialties
- Dermatologist
- MOHS-Micrographic Surgeon
- Dermatopathologist
- Pediatric Dermatologist
- Procedural Dermatology
Languages spoken
- English
Location
First Address
- Lynn Leroy Juracek
- 14239 W Bell Rd Suite 101
- Surprise, AZ
- Zip : 85374-2469
- Fax : (623) 544-8665
- Phone : (623) 544-7755
Second Address
- Lynn Leroy Juracek
- 14239 W Bell Rd Suite 101
- Surprise, AZ
- Zip : 85374-2469
- Fax : (623) 544-8665
- Phone : (623) 544-7755
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207N00000X | Dermatologist | 30022 | AZ |
| Y | 207ND0101X | MOHS-Micrographic Surgeon | 30022 | AZ |
| N | 207ND0900X | Dermatopathologist | 30022 | AZ |
| N | 207NP0225X | Pediatric Dermatologist | 30022 | AZ |
| N | 207NS0135X | Procedural Dermatology | 30022 | AZ |
National Provider Identifier
| NPI | 1083608699 |
|---|---|
| Provider Name | Lynn Leroy Juracek |
| First Address | Surprise, AZ 85374-2469 |
| Second Address | Surprise, AZ 85374-2469 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/09/2005 |
| Last Update Date | 15/05/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E91085 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.