Provider Demographics
NPI:1023323235
Name:JURASZEK, STEVEN JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:JURASZEK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PASS RD
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-3201
Mailing Address - Country:US
Mailing Address - Phone:228-864-4967
Mailing Address - Fax:
Practice Address - Street 1:2 PASS RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3201
Practice Address - Country:US
Practice Address - Phone:228-864-4967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist