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Individual

MICHAEL J SORENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1223 WILLOW CREEK RD, PRESCOTT, AZ 86301-1427
(928) 777-9950
(928) 777-9975
Mailing address
1223 WILLOW CREEK RD, PRESCOTT, AZ 86301-1427
(928) 777-9950
(928) 777-9975

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
60457
AZ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
60457
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000120000
MS
05
110318002
AR
01
1255827
CIGNA
TN
01
12608
TLC
TN
05
135333001
AR
01
250009146
RAILROAD MEDICARE
TN
01
3091702
BLUE CROSS
TN
05
3371161
TN
05
3825983
TN
01
5015681
AETNA
TN
01
620819926
BCBS
MS
01
620819926
TRICARE
TN
05
7187860
MS
Enumeration date
05/23/2005
Last updated
06/30/2022
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