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Individual

DR. NEIL L JORGENSEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7795
(618) 256-7635
Mailing address
1109 WOODLEAF DR, O FALLON, IL 62269-3150
(618) 632-8169

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
IL

Other

Enumeration date
10/04/2005
Last updated
07/08/2007
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