Individual
MICHAEL D JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 WALLACE BLVD, AMARILLO, TX 79106-1708
(806) 414-9970
(806) 351-3783
Mailing address
1400 WALLACE BLVD, AMARILLO, TX 79106-1708
(806) 414-9970
(806) 356-4673
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
H2493
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128199003
—
TX
05
—
128199006
—
TX
05
—
200219360 A
—
OK
01
—
853160
BCBS ID WITH GROUP
TX
01
—
A018
CHAMPUS ID WITH GROUP
TX
01
—
P00115086
RRMEDICARE ID
TX
05
—
V3692
—
NM
Enumeration date
05/23/2005
Last updated
02/26/2016
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