Provider Demographics
NPI:1275798563
Name:JORGENSON & KOKA LLP
Entity Type:Organization
Organization Name:JORGENSON & KOKA LLP
Other - Org Name:PRIMARY CARE CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:M
Authorized Official - Last Name:JORGENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-361-2273
Mailing Address - Street 1:9975 S EASTERN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7950
Mailing Address - Country:US
Mailing Address - Phone:702-492-7208
Mailing Address - Fax:702-407-5645
Practice Address - Street 1:9975 S EASTERN AVE STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-7950
Practice Address - Country:US
Practice Address - Phone:702-492-7208
Practice Address - Fax:702-407-5645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty