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General NPI Number Information
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NPI Number | 1588646830
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Entity Type | Individual
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Provider Name | CRAIG M JORGENSON MD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 3830 E FLAMINGO RD # 201
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City | LAS VEGAS
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State | NV
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Zip | 89121-6234
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Country | US
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Telephone | 702-659-5604
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Fax | 702-660-6186
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Provider Business Mailing Address
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Address Line | 1000 N GREEN VALLEY PKWY # 440-127
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City | HENDERSON
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State | NV
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Zip | 89074-6170
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Country | US
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Telephone | 702-492-7208
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Fax | 702-660-6186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 9529
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License Number State | NV
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