Individual
DR. MICHAEL KYLE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-2900
Mailing address
PO BOX 413021, SALT LAKE CITY, UT 84141-3021
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
50468
WI
208000000X
Pediatrics Physician
Primary
6019928-1205
UT
Other
Enumeration date
12/08/2006
Last updated
10/21/2021
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