Individual
RONALD C JENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4794 RED OAK LN, BLOOMINGTON, IN 47401-9100
(812) 396-9620
Mailing address
4794 RED OAK LN, BLOOMINGTON, IN 47401-9100
(812) 396-9620
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02000605
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100259020
—
IN
Enumeration date
12/29/2005
Last updated
03/26/2013
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