Provider Demographics
NPI:1841288552
Name:JENSEN, CHRIS S (MD)
Entity type:Individual
Prefix:
First Name:CHRIS
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 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-4433
Mailing Address - Fax:319-384-8054
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-4433
Practice Address - Fax:319-384-8054
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29870207ZC0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1115337Medicaid
IA33937OtherWELLMARK BCBS
IA0115337Medicaid
IA09772OtherWELLMARK BCBS
IAP00050277Medicare PIN
IA1115337Medicaid
IA0115337Medicaid
IAI9683Medicare PIN