# KEITH D. JORGENSEN, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679588339
- **Authorized official:** DR. KEITH D JORGENSEN MD (PRESIDENT)
- **Authorized official phone:** (603) 432-8104

## Contact information

- **Practice address:** 44 BIRCH ST, SUITE 304, DERRY, NH 03038-2752
- **Practice address phone:** (603) 432-8104
- **Practice address fax:** (603) 434-2629
- **Mailing address:** 44 BIRCH ST, SUITE 304, DERRY, NH 03038-2752
- **Mailing address phone:** (603) 432-8104
- **Mailing address fax:** (603) 434-2629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 7086 | NH | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 07/24/2008