Individual
DR. G F JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
422 N MAIN ST, OSHKOSH, WI 54901-4924
(920) 235-8500
(920) 303-5547
Mailing address
422 N MAIN ST, OSHKOSH, WI 54901-4924
(920) 235-8500
(920) 303-5547
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1506
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38504000
—
WI
Enumeration date
10/20/2005
Last updated
06/21/2011
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