| Doctor Name: | DR. JODI LYNNE VAN JURA |
| NPI Number: | 1023122157 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 35079730 |
| Business Practice Address: | 4000 Miamisburg Centerville Rd Suite 410 Miamisburg, OH - 453427615 |
| Business Phone Number: | 9373848773 |
| Business Fax Number: | 9373840794 |
| Mailing Address: | 1 Prestige Pl, Suite 550 MIAMISBURG |
| State: | OH |
| Postal Code: | 453423794 |
| Phone Number: | 9377522305 |
| Fax Number: | 9375227513 |
| NPI Enumeration Date: | 08/18/2006 |
| NPI Last Update Date: | 09/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 35079730 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |