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NPI Code Detail

MEDICARE: JEFFREY J JENSON M.D.

MEDICARE: JEFFREY J JENSON M.D.
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
1207Q00000XFamily Medicine Physician036112996IL

General Provider Information

NPI Number : 1740211390
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY J JENSON M.D.
Provider Business Mailing Address
First Line : PO BOX 372
Second Line :
City : MATTOON
State : IL
Zip : 61938-0372
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 HEALTH CENTER DR STE 302
Second Line :
City : MATTOON
State : IL
Zip : 61938-4644
Country : US
Telephone Number : 217-238-4850
Fax Number : 217-238-4855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 11/28/2025

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