Individual
JOEL J. JORGENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4021 SOUTH 700 EAST 300, SALT LAKE CITY, UT 84107
(800) 328-3085
Mailing address
610 FOREST RD, WAYNE, PA 19087-2324
(610) 688-5053
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD074015L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018722310008
—
PA
01
—
1318538
HIGHMARK BLUE SHIELD
PA
01
—
30028656
KEYSTONE MERCY
PA
01
—
5637183
CIGNA HMO/PPO
PA
01
—
7294643
AETNA
PA
Enumeration date
05/12/2006
Last updated
07/09/2007
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