MEDICARE: CRAIG M JORGENSON 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
1	207R00000X	Internal Medicine Physician	9529	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1588646830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG M JORGENSON MD

Provider Business Mailing Address
First Line	:	1000 N GREEN VALLEY PKWY # 440-127
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-6170
Country	:	US
Telephone Number	:	702-492-7208
Fax Number	:	702-660-6186

Provider Business Practice Location Address
First Line	:	3830 E FLAMINGO RD # 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6234
Country	:	US
Telephone Number	:	702-659-5604
Fax Number	:	702-660-6186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	06/05/2025

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