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NPI Code Detail

MEDICARE: DR. STEPHEN M. JENSEN D.O.

MEDICARE: DR. STEPHEN M. JENSEN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician0116025046VA
2207R00000XInternal Medicine PhysicianO-1547ID
3207R00000XInternal Medicine Physician64040WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
164040OTHERWIWI STATE LIC

General Provider Information

NPI Number : 1821351800
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN M. JENSEN D.O.
Provider Business Mailing Address
First Line : 900 ILLINOIS AVE
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-3114
Country : US
Telephone Number : 715-346-5000
Fax Number :
Provider Business Practice Location Address
First Line : 900 ILLINOIS AVE
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-3114
Country : US
Telephone Number : 715-346-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2012
Last Update Date : 04/20/2026

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