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
Phone: (603) 432-8104
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023081601 | NPPES |
| New Hampshire | MEDICAID | 30001523 |
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