Jensen, Shayne Raymond
Jensen, Shayne Raymond is an individual health care provider with primary practice located at 2201 Jenks Ave , Panama City FL 32405-4531. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Jensen, Shayne Raymond can be contacted via phone (850) 769-0325.Contact Information
Primary practice address
2201 Jenks Ave
Panama City FL 32405-4531
Phone: (850) 769-0325
Fax: (850) 769-4476
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | PO2867 | Florida |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | PO 2867 | Florida |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | PO2867 | Florida |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | PO2867 | Florida |
Profile Details
| NPI number | 1134139454 |
|---|---|
| LBN Legal business name | Jensen, Shayne Raymond |
| Credentials | DPM, FACFAS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Nov 18th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134139454 | NPPES |
| Florida | Other | 45803 | BLUECROSSBLUESHIELD GROUP |
| Florida | Other | 65657 | BLUECROSSBLUESHIELD GROUP |
| Florida | Other | 061666115 | BLUECROSSBLUESHIELD GROUP |
| Florida | Other | 480035194 | BLUECROSSBLUESHIELD GROUP |
| Florida | Other | CK8386 | BLUECROSSBLUESHIELD GROUP |
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