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Individual

SCOTT A JORGENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
13133 N PORT WASHINGTON RD, SUITE G18, MEQUON, WI 53097-2419
(262) 243-5000
(262) 243-5317
Mailing address
788 N JEFFERSON ST, SUITE 300/ATTN. KAAREN BUTZEN, MILWAUKEE, WI 53202-3718
(414) 272-8950
(414) 272-0859

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31133
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1184654725
WI
Enumeration date
07/03/2006
Last updated
11/09/2016
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