Healthcare Provider Details

I. General information

NPI: 1164469698
Provider Name (Legal Business Name): ROBERT JENSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 TOWN CENTER AVE
BIG SKY MT
59716-1713
US

IV. Provider business mailing address

915 HIGHLAND BLVD
BOZEMAN MT
59715-6902
US

V. Phone/Fax

Practice location:
  • Phone: 406-995-6995
  • Fax:
Mailing address:
  • Phone: 64-414-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD00043539
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMED-PHYS-LIC-34349
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34349
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: