| Harris R. Jensen, Md, Llc | |
|
3500 John F Kennedy Pkwy Suite 210 Fort Collins CO 80525-2635 | |
| (970) 416-8354 | |
| (970) 416-0354 |
| Full Name | Harris R. Jensen, Md, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3500 John F Kennedy Pkwy, Fort Collins, Colorado |
| Authorized Official Name and Position | Harris Robert Jensen (OWNER) |
| Authorized Official Contact | 9702173370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harris R. Jensen, Md, Llc 3500 John F Kennedy Pkwy Suite 210 Fort Collins CO 80525-2635 Ph: (970) 416-8354 | Harris R. Jensen, Md, Llc 3500 John F Kennedy Pkwy Suite 210 Fort Collins CO 80525-2635 Ph: (970) 416-8354 |
| NPI Number | 1073971685 |
|---|---|
| Provider Enumeration Date | 02/10/2016 |
| Last Update Date | 02/10/2016 |
| Medicare PECOS PAC ID | 2961707211 |
|---|---|
| Medicare Enrollment ID | O20160224000715 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073971685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Harris R Jensen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417963943 PECOS PAC ID: 1951391432 Enrollment ID: I20040517000287 |
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