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Individual

DR. PETER C JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 630-7582
(317) 630-7694
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01074216A
IN
208600000X
Surgery Physician
4301101564
MI
208600000X
Surgery Physician
MT185869
PA
2086S0102X
Surgical Critical Care Physician
01074216A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201233600
IN
Enumeration date
01/04/2007
Last updated
09/13/2022
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