Provider Demographics
NPI:1326306630
Name:JENSEN, BURKLEY (DPM)
Entity type:Individual
Prefix:
First Name:BURKLEY
Middle Name:
Last Name:JENSEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546-4081
Mailing Address - Country:US
Mailing Address - Phone:928-348-3700
Mailing Address - Fax:928-348-3705
Practice Address - Street 1:2240 W 16TH ST
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-4081
Practice Address - Country:US
Practice Address - Phone:928-348-3700
Practice Address - Fax:928-348-3705
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND76213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist