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Individual

MARK D JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3506 21ST ST STE 507, LUBBOCK, TX 79410-1233
(806) 725-4860
(806) 723-7815
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
M6212
TX
207XX0801X
Orthopaedic Trauma Physician
Primary
M6212
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
187029701
TX
Enumeration date
06/13/2006
Last updated
07/18/2022
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