Individual
DR. DAVID LAURTIZ JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3090 N LITCHFIELD RD STE 120, GOODYEAR, AZ 85395-9214
(801) 874-3135
Mailing address
3090 N LITCHFIELD RD STE 120, GOODYEAR, AZ 85395-9214
(801) 874-3135
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
005379
AZ
207Q00000X
Family Medicine Physician
9167838-8904
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174855159
NPI
AZ
05
—
569756
—
AZ
Enumeration date
02/02/2010
Last updated
11/25/2019
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