Individual
DR. JERRY JENKINS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
533 GANDY ST NE, RUSSELLVILLE, AL 35653-1965
(256) 331-3338
(256) 331-2890
Mailing address
PO BOX 1412, RUSSELLVILLE, AL 35653-3212
(256) 331-3338
(256) 331-2890
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
M221
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480029801
RAILROAD
AL
05
—
DPM221
—
AL
Enumeration date
09/19/2005
Last updated
08/21/2012
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