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NPI Code Detail

MEDICARE: KURT J JORGENSEN MD

MEDICARE: KURT J JORGENSEN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician23450WI
2207Q00000XFamily Medicine Physician21148IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467458844
Entity Type Code : Individual
Provider Name (Legal Business Name) : KURT J JORGENSEN MD
Provider Business Mailing Address
First Line : 1836 SOUTH AVE
Second Line :
City : LA CROSSE
State : WI
Zip : 54601-5429
Country : US
Telephone Number : 608-782-7300
Fax Number :
Provider Business Practice Location Address
First Line : 610 E TAYLOR ST
Second Line :
City : PRAIRIE DU CHIEN
State : WI
Zip : 53821-2109
Country : US
Telephone Number : 608-326-6466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 09/13/2010

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