Individual
NICHOLAS PAIGE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12851 BROAD ST STE 100, CARMEL, IN 46032-7445
(463) 220-3486
(317) 449-8632
Mailing address
12851 BROAD ST STE 100, CARMEL, IN 46032-7445
(463) 220-3486
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01066864A
IN
208000000X
Pediatrics Physician
01066864A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200953650
—
IN
Enumeration date
05/30/2007
Last updated
05/28/2024
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