Organization
HARVEY C JENKINS PH D M D PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TASHONDA RENEE DIXON (PRACTICE MANAGER)
(405) 686-1700
Entity
Organization
Contact information
Practice address
8603 S WESTERN AVE, OKLAHOMA CITY, OK 73139-9200
(405) 686-1700
(405) 686-1555
Mailing address
8603 S WESTERN AVE, OKLAHOMA CITY, OK 73139-9200
(405) 686-1700
(405) 686-1555
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21473
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034590A
—
OK
01
—
37D1102406
CLIA LABORATORY
OK
Enumeration date
11/26/2007
Last updated
08/21/2012
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