Individual
DR. MARK R. JENKINS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
C30462
CA
2085R0202X
Diagnostic Radiology Physician
Primary
MD.009980
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08238561
—
MS
05
—
1012947
—
LA
01
—
P00417482
RAILROAD MEDICARE
—
Enumeration date
03/26/2007
Last updated
12/03/2007
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