Individual
DR. TESSY C JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
27200 LAHSER RD, SUITE 100, SOUTHFIELD, MI 48034
(248) 208-9215
(248) 208-9217
Mailing address
27200 LAHSER RD, SUITE 100, SOUTHFIELD, MI 48034
(248) 208-9215
(248) 208-9217
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301058568
MI
2084N0600X
Clinical Neurophysiology Physician
4301058568
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306303571
BCBS
MI
05
—
4639614
—
MI
01
—
5535883
FIRST HEALTH
MI
01
—
7794125
AETNA
MI
01
—
G35452
HEALTH ALLIANCE PLAN
MI
01
—
P111695
BLUECARE NETWORK
MI
Enumeration date
07/19/2005
Last updated
10/18/2010
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