Individual
JACOB DARRELL JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
UNM DEPARTMENT OF EMERGENCY MEDICINE-MSC11 6025, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-5062
Mailing address
UNMMG, 933 BRADBURY SE, SUITE 2222, ALBUQUERQUE, NM 87106
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
125065738
IL
207P00000X
Emergency Medicine Physician
Primary
A-2047-17
NM
207P00000X
Emergency Medicine Physician
O-1304
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-2047-17
NM BOARD OF OSTEOPATHIC MEDICINE
NM
01
—
O-1304
STATE MEDICINE LICENSING BOARD
ID
Enumeration date
07/11/2012
Last updated
11/18/2024
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