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Individual

WILL C JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3931 LOUISIANA AVE S, SAINT LOUIS PARK, MN 55426-4375
(952) 993-3123
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01093364A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01093364A
IN
207RP1001X
Pulmonary Disease Physician
01093364A
IN
207RP1001X
Pulmonary Disease Physician
Primary
82605
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1104175832
ANTHEM PTAN
IN
05
300092138
IN
Enumeration date
03/22/2018
Last updated
07/17/2026
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