Individual
HUNTER DALE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2501 PARKERS LN # SURGERY, ALEXANDRIA, VA 22306-3209
(703) 664-7000
Mailing address
220 MULBERRY LN, WILEY FORD, WV 26767-8027
(301) 268-5054
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110-009016
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/06/2022
Last updated
12/15/2022
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