Individual
PETER MERRILL JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1208 HILLTOP DR, SUITE 200, ROCK SPRINGS, WY 82901-5857
(307) 382-4114
(307) 382-4131
Mailing address
1208 HILLTOP DR, SUITE 200, ROCK SPRINGS, WY 82901-5857
(307) 382-4114
(307) 382-4131
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
5692A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110943000
—
WY
Enumeration date
01/19/2006
Last updated
08/12/2015
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