Individual
EVERETTE EARL JENKINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 S HERLONG AVE, ROCK HILL, SC 29732-1158
(803) 329-1234
Mailing address
PO BOX 6426, CHRISTIANSBURG, VA 24068-6426
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
8250
SC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
8250
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082500
—
SC
01
—
25942
MEDCOST
—
Enumeration date
08/19/2005
Last updated
02/20/2012
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