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Individual

DR. JOHN MARTIN JENSEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1786C COLUMBIA AVE, COLUMBIA, PA 17512-9508
(717) 684-3663
(717) 684-9030
Mailing address
409 SOUTH SECOND STREET, SUITE 2F, HARRISBURG, PA 17104-1612

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS004334L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000100197
HIGHMARK BS
05
0006437080004
PA
01
001531598
HIGHMARK BLUE SHIELD
01
01073601
CAPITAL BLUE CROSS
PA
01
02300000
CAPITAL BLUE CROSS
Enumeration date
03/29/2006
Last updated
07/03/2017
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