Individual
DR. SHANE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
415 E. CENTER STREET, PANGUITCH, UT 84759
(435) 676-8646
(435) 676-8646
Mailing address
P.O. BOX 592, PANGUITCH, UT 84759
(435) 676-2761
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5354482-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043753766
TRICARE
UT
01
—
107028627101
IHC
UT
01
—
1595696
OPTICHOICE
UT
01
—
270343
ALTIUS
UT
01
—
5354482-9934
PEHP
UT
01
—
53544829900001
BLUECROSS BLUESHIELD
UT
01
—
813540
DMBA
UT
05
—
D5075
—
UT
01
—
RR27009
SPECTERA
UT
Enumeration date
09/26/2006
Last updated
06/16/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us