Randell Peter Jura
Family Doctor - Adult Medicine
4666 Commercial St Se
Salem
, Oregon 97302-1902
Randell Peter Jura
Family Doctor - Adult Medicine
4666 Commercial St Se
Salem
, Oregon 97302-1902
(503) 364-1016
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Randell Peter Jura
- 4666 Commercial St Se
- Salem, OR
- Zip : 97302-1902
- Fax : (503) 364-1016
- Phone : (503) 399-7607
Second Address
- Randell Peter Jura
- 4666 Commercial St Se
- Salem, OR
- Zip : 97302-1902
- Fax : (503) 364-1016
- Phone : (503) 399-7607
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | 12431 | OR |
National Provider Identifier
| NPI | 1104272921 |
|---|---|
| Provider Name | Randell Peter Jura |
| First Address | Salem, OR 97302-1902 |
| Second Address | Salem, OR 97302-1902 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/05/2016 |
| Last Update Date | 11/05/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0000BHPBD | OREGON WORKERS COMP (01) | OR |
| 26053-9 | (05) | OR |
| C94383 | (02) | OR |
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.