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Individual

KURT J JORGENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
610 E TAYLOR ST, PRAIRIE DU CHIEN, WI 53821-2109
(608) 326-6466
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
21148
IA
207Q00000X
Family Medicine Physician
Primary
23450
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30353700
WI
Enumeration date
06/22/2005
Last updated
09/13/2010
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