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Individual

ASHLEY W JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
820 4TH ST N, FARGO, ND 58102-4539
(701) 234-6161
Mailing address
820 4TH ST N, FARGO, ND 58102-4539
(701) 234-6161

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
11822
ND
2085R0001X
Radiation Oncology Physician
48922
MN
2085R0001X
Radiation Oncology Physician
51933-020
WI
2085R0001X
Radiation Oncology Physician
MD125825
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15606
ND
05
487480000
MN
01
P00405196
MEDICARE RAILROAD
MN
Enumeration date
07/27/2006
Last updated
11/18/2011
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