Individual
KENNETH F. JENSEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21735
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30317300
—
WI
01
—
P00449578
RR MEDICARE
WI
Enumeration date
07/11/2006
Last updated
12/23/2010
Update your record
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