Jenson, Mark K

Jenson, Mark K is an individual health care provider with primary practice located at 124 Siegler St , Green Bay WI 54303-2636. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jenson, Mark K can be contacted via phone (920) 494-9661.

Contact Information

Primary practice address
124 Siegler St Green Bay WI 54303-2636
Phone: (920) 494-9661
Fax: (920) 496-3792
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29927 Wisconsin

Profile Details

NPI number 1598727000
LBN Legal business name Jenson, Mark K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2006
Last updated Nov 5th, 2012 - about 14 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 1598727000 NPPES
Wisconsin MEDICAID 31473000

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