# ROGER JENKINS MD PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144415084
- **Authorized official:** DR. ROGER C. JENKINS MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (928) 717-0077

## Contact information

- **Practice address:** 172 E MERRITT ST, SUITE C, PRESCOTT, AZ 86301-2026
- **Practice address phone:** (928) 717-0077
- **Practice address fax:** (928) 717-0141
- **Mailing address:** 172 E MERRITT ST, SUITE C, PRESCOTT, AZ 86301-2026
- **Mailing address phone:** (928) 717-0077
- **Mailing address fax:** (928) 717-0141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 34543 | AZ | Yes |

## Other

- **Enumeration date:** 09/13/2007
- **Last updated:** 09/13/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 34543 | LICENSE NUMBER | AZ |