Provider Demographics
NPI:1164952669
Name:JENSEN, HANS (DO)
Entity Type:Individual
Prefix:DR
First Name:HANS
Middle Name:
Last Name:JENSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 SPROUL RD STE 140
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3512
Mailing Address - Country:US
Mailing Address - Phone:610-325-0309
Mailing Address - Fax:
Practice Address - Street 1:1991 SPROUL RD STE 140
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3512
Practice Address - Country:US
Practice Address - Phone:610-325-0309
Practice Address - Fax:610-325-0459
Is Sole Proprietor?:No
Enumeration Date:2017-06-16
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine