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Individual

CHESTER W JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 S WASHINGTON AVE, GREENVILLE, MS 38701-4719
(662) 725-1025
(662) 725-1023
Mailing address
PO BOX 4739, GREENVILLE, MS 38704-4739
(662) 725-2749
(662) 725-2741

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
00005814
AL
2084P0800X
Psychiatry Physician
012716
GA
2084P0800X
Psychiatry Physician
Primary
15598
MS
2084P0800X
Psychiatry Physician
MD0000029544
TN
2084P0800X
Psychiatry Physician
N8305
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02472042
MS
05
121968001
AR
Enumeration date
07/12/2005
Last updated
10/24/2011
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