Jensen, Jedediah Lars

Jensen, Jedediah Lars is an individual health care provider with primary practice located at 709 Spring Valley Rd , Burlington WI 53105-7614. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Jensen, Jedediah Lars can be contacted via phone (262) 971-1900.

Contact Information

Primary practice address
709 Spring Valley Rd Burlington WI 53105-7614
Phone: (262) 971-1900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 5101018776 Michigan
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 5101018776 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 5101018776 Michigan
Allopathic & Osteopathic Physicians / Sports Medicine 207RS0010X 73430 Wisconsin

Profile Details

NPI number 1952621872
LBN Legal business name Jensen, Jedediah Lars
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2010
Last updated Dec 6th, 2021 - about 5 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 1952621872 NPPES
Wisconsin MEDICAID 100100259

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