Individual
DOUGLAS P JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5859 W TALAVI BLVD, SUITE 100, GLENDALE, AZ 85306-1869
(602) 298-7777
(623) 930-6060
Mailing address
PO BOX 52886, PHOENIX, AZ 85072-2886
(602) 298-7777
(623) 930-6060
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11306
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211681
—
AZ
Enumeration date
09/21/2005
Last updated
08/26/2011
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