Organization
JERRY JENKINS II DPM
Active
Other names
RUSSELLVILLE PODIATRY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY JENKINS II D.P.M. (SOLE PROPRIETOR)
(256) 331-3338
Entity
Organization
Contact information
Practice address
533 GANDY ST NE, RUSSELLVILLE, AL 35653-1965
(256) 331-3338
(256) 331-2890
Mailing address
PO BOX 5268, BELFAST, ME 04915-5200
(256) 331-3338
(256) 331-2890
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
221
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DPM221
—
AL
Enumeration date
04/10/2008
Last updated
02/04/2013
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