Individual
MICHAEL D JENKINS
Active
Individual
MICHAEL D JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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