Jensen, Gregory R

Jensen, Gregory R is an individual health care provider with primary practice located at 300 S 3Rd W , Soda Springs ID 83276-1559. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Jensen, Gregory R can be contacted via phone (208) 547-3341.

Contact Information

Primary practice address
300 S 3Rd W Soda Springs ID 83276-1559
Phone: (208) 547-3341
Fax: (208) 547-2790
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X O-1191 Idaho
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X O-1191 Idaho

Profile Details

NPI number 1558894220
LBN Legal business name Jensen, Gregory R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2017
Last updated May 24th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558894220 NPPES
Idaho MEDICAID 1942970272
Idaho MEDICAID 1669533154

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