Provider Demographics
NPI:1376109777
Name:JORGENSEN, ALEXIS ANNE (MD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ANNE
Last Name:JORGENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:ANNE
Other - Last Name:BLIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3737 MARKET ST FL 6
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5545
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3737 MARKET ST FL 6
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5545
Practice Address - Country:US
Practice Address - Phone:267-825-3679
Practice Address - Fax:215-349-5890
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12296700207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery