Jenkins, John L

Jenkins, John L is an individual health care provider with primary practice located at 621 Memorial Dr Ste 502, South Bend IN 46601-1075. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Jenkins, John L can be contacted via phone (574) 234-9001.

Contact Information

Primary practice address
621 Memorial Dr Ste 502 South Bend IN 46601-1075
Fax: (574) 287-5367
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 01025732 Indiana

Profile Details

NPI number 1003818212
LBN Legal business name Jenkins, John L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Oct 6th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003818212 NPPES
Indiana MEDICAID 100325320A

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