Organization
MARK A. JENKINS, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A JENKINS M.D. (OWNER)
(336) 634-0095
Entity
Organization
Contact information
Practice address
1818 RICHARDSON DR, SUITE E, REIDSVILLE, NC 27320-5451
(336) 634-0095
(336) 616-0320
Mailing address
1818 RICHARDSON DR, SUITE E, REIDSVILLE, NC 27320-5451
(336) 634-0095
(336) 616-0320
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9400533
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1701768
UHC
NC
01
—
45870
BCBS
NC
01
—
52454
MEDCOST
NC
01
—
8284
PARTNERS
NC
05
—
8945870
—
NC
01
—
D44070
UPIN
NC
Enumeration date
07/30/2008
Last updated
07/30/2008
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