Provider Demographics
NPI:1407858418
Name:JENSEN, LLOYD R (MD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:R
Last Name:JENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3131 LACANADA ST
Mailing Address - Street 2:SUITE 244
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169
Mailing Address - Country:US
Mailing Address - Phone:702-697-0082
Mailing Address - Fax:702-691-9984
Practice Address - Street 1:3186 S MARYLAND PKWY
Practice Address - Street 2:SUNRISE CHILDRENS HOSPITAL NICU
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169
Practice Address - Country:US
Practice Address - Phone:702-731-8240
Practice Address - Fax:702-693-5331
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV16964208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID003760900Medicaid
IDG07830Medicare UPIN