Provider Demographics
NPI:1518013143
Name:JENSEN, GEOFFREY S (MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:S
Last Name:JENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10103 RIDGEGATE PKWY
Mailing Address - Street 2:STE. 312
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5520
Mailing Address - Country:US
Mailing Address - Phone:303-788-8888
Mailing Address - Fax:866-456-4594
Practice Address - Street 1:10103 RIDGEGATE PKWY
Practice Address - Street 2:STE. 312
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5520
Practice Address - Country:US
Practice Address - Phone:303-788-8888
Practice Address - Fax:866-456-4594
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42835207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE84081574413Medicaid
WY127413900Medicaid
COP00887339OtherMEDICARE RAILROAD
CO80350852Medicaid
COCO305182Medicare PIN
COI24817Medicare UPIN