DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. SHANE JENSEN, O.D.

Active Sole Proprietor

DR. SHANE JENSEN, O.D. is a Optometrist healthcare provider located in PANGUITCH, Utah. NPI 1154422822 is currently active in the NPPES registry. Verify at CMS.

Optometrist · PANGUITCH, UT

Registration Details

NPI Number
1154422822
Provider Type
Individual
Gender
Male
NPI Issued
Sep 26, 2006 (19.698446693356 yrs)
Last Updated
Jun 16, 2008
License
5354482-9934 (UT)
Sole Proprietor
Yes

Practice Information

Address
415 E. CENTER STREET
PANGUITCH, UT, 84759
Browse UT providers · Browse ZIP 84759
Phone
4356768646
Fax
4356768646
Primary Specialty
Optometrist
152W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.