Individual
JEREMIAH JORGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3584 W 9000 S, SUITE 405, WEST JORDAN, UT 84088-5710
(801) 568-3480
(801) 568-3482
Mailing address
6460 MEDICAL CENTER ST STE 350, LAS VEGAS, NV 89148-2423
(702) 255-6647
(702) 933-1444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4597
AZ
363A00000X
Physician Assistant
Primary
8152398-1206
UT
363A00000X
Physician Assistant
PA2046
NV
Other
Enumeration date
02/09/2010
Last updated
06/09/2019
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