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Individual

MARK H JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1248 E 90 N STE 103, AMERICAN FORK, UT 84003-2954
(801) 852-9560
(801) 852-9559
Mailing address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6695
(801) 374-9625
(801) 374-9690

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
47680
MN
208200000X
Plastic Surgery Physician
Primary
7903019-1205
UT
208600000X
Surgery Physician
47680
MN
208600000X
Surgery Physician
7903019-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34841700
WI
05
425475900
MN
05
ENROLLED
IA
01
P00746335
RAILROAD MEDICARE
MN
Enumeration date
01/06/2006
Last updated
03/13/2026
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