Individual
SCOTT M JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
204 LEWIS AVE S STE 201, WATERTOWN, MN 55388-4502
(952) 955-1963
(952) 955-1965
Mailing address
204 LEWIS AVE S, WATERTOWN, MN 55388-4500
(952) 955-1963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26965
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26965
MEDICAL LICENSE
MN
05
—
423268200
—
MN
Enumeration date
11/30/2005
Last updated
01/02/2019
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