Organization
JERRY JENKINS II DPM
Active
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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