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General NPI Number Information
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NPI Number | 1821910472
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Entity Type | Organization
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Legal Business Name | JENSEN ORTHOPEDICS
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 2996 N AJAX AVE
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City | EAGLE
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State | ID
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Zip | 83616-1077
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Country | US
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Telephone | 208-605-3662
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Fax |
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Provider Business Mailing Address
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Address Line | 2996 N AJAX AVE
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City | EAGLE
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State | ID
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Zip | 83616-1077
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAY JENSEN
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Credential | MD
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Telephone | 208-605-3662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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