Individual
DR. MARK R. JENKINS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1415 TULANE AVE, HC 71, NEW ORLEANS, LA 70112-2600
(504) 988-5800
Mailing address
1415 TULANE AVE, HC 71, NEW ORLEANS, LA 70112-2600
(504) 988-5800
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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