Healthcare Provider Details

I. General information

NPI: 1396961686
Provider Name (Legal Business Name): JEFFREY L JENSEN DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 HALE PKWY STE 440
DENVER CO
80220-4000
US

IV. Provider business mailing address

4600 HALE PKWY STE 440
DENVER CO
80220-4000
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-4477
  • Fax: 303-321-5323
Mailing address:
  • Phone: 303-321-4477
  • Fax: 303-321-5323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number469
License Number StateCO

VIII. Authorized Official

Name: RAMONA HALEY
Title or Position: OFICE MGR
Credential:
Phone: 303-321-4477