Individual
DR. BRIAN K JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18404 N TATUM BLVD, SUITE 205, PHOENIX, AZ 85032-1509
(602) 971-5500
(602) 944-0504
Mailing address
18404 N TATUM BLVD, SUITE 205, PHOENIX, AZ 85032-1509
(602) 971-5500
(602) 944-0504
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25981
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110213981
RR MEDICARE
—
01
—
25981
AZ LICENSE
—
Enumeration date
08/04/2006
Last updated
03/30/2011
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