Jensen, Mark A
Jensen, Mark A is an individual health care provider with primary practice located at 2217 Dubois Dr , Warsaw IN 46580-3212. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Jensen, Mark A can be contacted via phone (574) 267-8940.Contact Information
Primary practice address
2217 Dubois Dr
Warsaw IN 46580-3212
Phone: (574) 267-8940
Fax: (574) 267-5782
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 01033577 | Indiana |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 01033577 | Indiana |
Profile Details
| NPI number | 1093715062 |
|---|---|
| LBN Legal business name | Jensen, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Aug 28th, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093715062 | NPPES |
| Indiana | MEDICAID | 100157230A |
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