Individual
EWIN B JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1103 16TH AVE SE, DECATUR, AL 35601-3595
(256) 350-0362
Mailing address
1103 16TH AVE SE, DECATUR, AL 35601-3595
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
00006964
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51003218
BLUECROSS BLUESHIELD OF A
AL
Enumeration date
11/15/2006
Last updated
10/22/2007
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