Doctor Name: | PETER E JENSEN |
NPI Number: | 1033215686 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 188598-1205 |
Business Practice Address: | 9690 S 1300 E Suite 224 Sandy, UT - 840943721 |
Business Phone Number: | 8015018346 |
Business Fax Number: | 8015012627 |
Mailing Address: | 9690 S 1300 E, Suite 224 SANDY |
State: | UT |
Postal Code: | 840943721 |
Phone Number: | 8015018346 |
Fax Number: | 8015012627 |
NPI Enumeration Date: | 09/14/2006 |
NPI Last Update Date: | 02/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | 188598-1205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |