| Jeremiah Jorgensen, PA | |
|
148 S 1100 E, American Fork, UT 84003-2817 | |
| (385) 336-7461 | |
| Not Available |
| Full Name | Jeremiah Jorgensen |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 148 S 1100 E, American Fork, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669704045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 8152398-1206 (Utah) | Primary |
| 363A00000X | Physician Assistant | 4597 (Arizona) | Secondary |
| 363A00000X | Physician Assistant | PA2046 (Nevada) | Secondary |
| Entity Name | Wasatch Dermatology PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891176939 PECOS PAC ID: 9638488240 Enrollment ID: O20151022000655 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremiah Jorgensen, PA 6460 Medical Center St Ste 350, Las Vegas, NV 89148-2423 Ph: (702) 255-6647 | Jeremiah Jorgensen, PA 148 S 1100 E, American Fork, UT 84003-2817 Ph: (385) 336-7461 |
Rachel H Lund, PHYSICIAN ASSISTANT Physician Assistant Medicare: Medicare Enrolled Practice Location: 538 S 500 E, American Fork, UT 84003 Phone: 801-642-2000 |
Lexis Amanda Cooper, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1248 E 90 N # 300, American Fork, UT 84003 Phone: 801-756-9635 |
Andrew Benjamin Ward, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1184 E 80 N, American Fork, UT 84003 Phone: 801-763-3885 Fax: 801-763-3887 |
Megan Sterling, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 212 S 1100 E # A, American Fork, UT 84003 Phone: 801-763-0901 |
James Nguyen, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 98 N 1100 E Ste 203, American Fork, UT 84003 Phone: 801-492-2445 |
Stephen A Loper, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1159 E 200 N Ste 300, American Fork, UT 84003 Phone: 801-753-4712 |
Ms. Marla Morillo, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1159 E 200 N Ste 250, American Fork, UT 84003 Phone: 801-855-2980 |