Provider Demographics
NPI:1780862862
Name:BOYSEN, JESS (MD)
Entity type:Individual
Prefix:
First Name:JESS
Middle Name:
Last Name:BOYSEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC493
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6533 DREW AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2103
Practice Address - Country:US
Practice Address - Phone:952-924-4039
Practice Address - Fax:952-924-4021
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2021-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN55863207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology