Jorgensen, Keith D

Jorgensen, Keith D is an individual health care provider with primary practice located at 44 Birch St Suite 304, Derry NH 03038-2752. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Jorgensen, Keith D can be contacted via phone (603) 432-8104.

Contact Information

Primary practice address
44 Birch St Suite 304 Derry NH 03038-2752
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 7086 New Hampshire

Profile Details

NPI number 1023081601
LBN Legal business name Jorgensen, Keith D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Mar 24th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023081601 NPPES
New Hampshire MEDICAID 30001523

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