| Shane R Jensen | |
|
415 East Center Street, Panguitch, UT 84759 | |
| (435) 676-8646 | |
| (435) 676-8646 |
| Full Name | Shane R Jensen |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 415 East Center Street, Panguitch, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548459068 | NPI | - | NPPES |
| 528211323001 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 53544829934 (Utah) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Shane R Jensen 415 East Center Street, Panguitch, UT 84759 Ph: (435) 676-8646 | Shane R Jensen 415 East Center Street, Panguitch, UT 84759 Ph: (435) 676-8646 |
Dr. Shane Jensen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 415 E. Center Street, Panguitch, UT 84759 Phone: 435-676-8646 Fax: 435-676-8646 | |
Southwest Vision, Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 415 E Center St, Panguitch, UT 84759 Phone: 435-676-8646 Fax: 435-676-8647 |