Individual
ERIC J JENKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 LIBERTY ST, REDDING, CA 96001-0814
(530) 246-2467
(530) 246-5632
Mailing address
PO BOX 991950, REDDING, CA 96099-1950
(530) 246-2457
(530) 246-5632
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
01050809A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200216530
—
IN
01
—
250011958
RAIL ROAD MEDICARE
IN
Enumeration date
07/15/2005
Last updated
08/03/2020
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