Individual
DR. JASON WILLIAM DENBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
176 CRESTMERE PL, MEMPHIS, TN 38112-3202
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
62506
MN
2086X0206X
Surgical Oncology Physician
Q1587
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343113201 (MDACC)
—
TX
01
—
8ET732 (MDACC)
BCBS
TX
Enumeration date
08/12/2007
Last updated
01/18/2018
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