Individual
DR. JACK HENSOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
931 HIGHLAND BLVD STE 3130, BOZEMAN, MT 59715-6914
(406) 585-5070
Mailing address
931 HIGHLAND BLVD STE 3130, BOZEMAN, MT 59715-6914
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
10576
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140624
—
MT
01
—
97535
BLUE CROSS OF MT
MT
01
—
P00225963
MEDICARE RAILROAD
—
Enumeration date
08/03/2006
Last updated
08/06/2021
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