Organization
EMIR PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES JENKINS III NP (NURSE PRACTITIONER)
(404) 366-3647
Entity
Organization
Contact information
Practice address
4930 GOVERNORS DR STE 409, FOREST PARK, GA 30297-6101
(404) 366-3647
(404) 366-3648
Mailing address
4930 GOVERNORS DR STE 409, FOREST PARK, GA 30297-6101
(404) 366-3647
(404) 366-3648
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
RN143268
GA
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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