Individual
JEFFREY J JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R8N52
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164528204
—
MO
05
—
208144220
—
MO
01
—
P00294297
RR MEDICARE
—
Enumeration date
09/16/2006
Last updated
09/12/2024
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