Individual
THOMAS R. JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10101 S 27TH ST, FRANKLIN, WI 53132-7209
(414) 325-4940
Mailing address
10101 S 27TH ST, FRANKLIN, WI 53132-7209
(414) 325-4940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25148
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30931600
—
WI
01
—
P00449580
RR MEDICARE
WI
Enumeration date
07/07/2006
Last updated
04/27/2010
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