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Individual

JERRY H JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2427 FM 3258, LUFKIN, TX 75904-0683
(936) 676-1030
(936) 875-5197
Mailing address
2427 FM 3258, LUFKIN, TX 75904-0683
(936) 676-1030
(936) 875-5197

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J8603
TX
207Q00000X
Family Medicine Physician
J8603
TX
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
J8603
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
172791901
TX
Enumeration date
06/28/2006
Last updated
02/12/2016
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