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1992729230

NPI Code Detail

MEDICARE: ASHLEY W JENSEN MD

MEDICARE: ASHLEY W JENSEN MD

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
1	2085R0001X	Radiation Oncology Physician	48922	MN
2	2085R0001X	Radiation Oncology Physician	11822	ND
3	2085R0001X	Radiation Oncology Physician	MD125825	OR
4	2085R0001X	Radiation Oncology Physician	51933-020	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00405196	OTHER	MN	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992729230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY W JENSEN MD

Provider Business Mailing Address
First Line	:	820 4TH ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-4539
Country	:	US
Telephone Number	:	701-234-6161
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 4TH ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-4539
Country	:	US
Telephone Number	:	701-234-6161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	11/18/2011

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Directions to “ ASHLEY W JENSEN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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