Individual
KENNETH MICHAEL JORGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9660 S 1300 E, SANDY, UT 84094-3762
(801) 269-2696
(801) 269-2690
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(801) 269-2696
(801) 269-2690
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
339837-1205
UT
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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