Individual
DR. MARK A JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2217 DUBOIS DR, WARSAW, IN 46580-3212
(574) 267-8940
(574) 267-5782
Mailing address
2217 DUBOIS DR, WARSAW, IN 46580-3212
(574) 267-8940
(574) 267-5782
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01033577
IN
208600000X
Surgery Physician
Primary
01033577
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100157230A
—
IN
Enumeration date
07/29/2005
Last updated
08/28/2009
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