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Individual

CRAIG R JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 C ST, SALT LAKE CITY, UT 84143-1005
(801) 993-9582
(801) 733-5618
Mailing address
2975 EXECUTIVE PKWY, 200, LEHI, UT 84043-9642
(801) 990-1911
(801) 990-1912

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
84-172383-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107005209101
IHC
UT
01
11228
DESERET MUTUAL
UT
01
1502954
UMWA
UT
01
2090168
UNITED HEALTHCARE
UT
01
37794
PEHP
UT
01
546180
HEALTHY U
UT
05
820896
AZ
01
8597445
WORKERS COMP
UT
01
870545614JE1
EDUCATORS MUTUAL
UT
01
PRA02721
MOLINA
UT
01
QM0000075886
ALTIUS
UT
Enumeration date
09/13/2006
Last updated
07/08/2007
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