Individual
ERIC JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-4700
Mailing address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-4700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-13831
ID
207Q00000X
Family Medicine Physician
MRM-1497
ID
Other
Enumeration date
06/22/2015
Last updated
01/06/2024
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