Individual
WALTER THOMAS JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 297-2200
(770) 534-8139
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
015385
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000153777C
—
GA
05
—
000153777H
—
GA
05
—
000153777I
—
GA
01
—
0700332
UNITED HEALTHCARE
GA
01
—
10050576
AMERIGROUP
GA
01
—
160029720
RR MEDICARE-GRP # CC4177
GA
01
—
1619821
CIGNA
GA
01
—
340855
WELLCARE
GA
01
—
52348753
BCBS
GA
Enumeration date
01/23/2006
Last updated
07/26/2011
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