Individual
JESSE JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
420 POLIFKA DR BLDG 1042, SHAW AFB, SC 29152-5100
(803) 717-7099
Mailing address
420 POLIFKA DR BLDG 1042, SHAW AFB, SC 29152-5100
(038) 717-7099
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/01/2016
Last updated
08/22/2024
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