Individual
RICKY C JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1310 W 22ND ST, SIOUX FALLS, SD 57105-1501
(605) 328-8200
(605) 328-8201
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-4538
(605) 328-4531
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
10034
MT
207Y00000X
Otolaryngology Physician
Primary
5933
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0044540
—
MT
Enumeration date
08/02/2005
Last updated
05/09/2008
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