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General NPI Number Information
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NPI Number | 1649614389
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Entity Type | Organization
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Legal Business Name | ALAN D JENSEN MD P C
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 8761 W CENTER RD STE B
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City | OMAHA
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State | NE
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Zip | 68124-2166
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Country | US
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Telephone | 402-397-6060
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Fax | 402-398-0336
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Provider Business Mailing Address
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Address Line | 8761 W CENTER RD STE B
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City | OMAHA
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State | NE
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Zip | 68124-2166
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Country | US
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Telephone | 402-397-6060
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Fax | 402-398-0336
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Authorized Official
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Title or Position | PREIDENT
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Name | DR. ALAN DEAN JENSEN
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Credential | MD
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Telephone | 402-397-6060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 17820
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License Number State | NE
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