| Doctor Name: | DR. EDWARD BRIAN JORGENSEN |
| NPI Number: | 1356325963 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OS6227 |
| Business Practice Address: | 14114 Alabama St Jay Hospital Jay, FL - 32565 |
| Business Phone Number: | 8506758035 |
| Business Fax Number: | |
| Mailing Address: | 14114 Alabama St, Jay Hospital JAY |
| State: | FL |
| Postal Code: | 32565 |
| Phone Number: | 8506758035 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2005 |
| NPI Last Update Date: | 05/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | OS6227 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |