Jenson, Mark K
Jenson, Mark K is an individual health care provider with primary practice located at 124 Siegler St , Green Bay WI 54303-2636. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jenson, Mark K can be contacted via phone (920) 494-9661.Contact Information
Primary practice address
124 Siegler St
Green Bay WI 54303-2636
Phone: (920) 494-9661
Fax: (920) 496-3792
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 29927 | Wisconsin |
Profile Details
| NPI number | 1598727000 |
|---|---|
| LBN Legal business name | Jenson, Mark K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 3rd, 2006 |
| Last updated | Nov 5th, 2012 - about 12 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 | 1598727000 | NPPES |
| Wisconsin | MEDICAID | 31473000 |
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