Jenkins, Shannon

Jenkins, Shannon is an individual health care provider with primary practice located at 2860 Channing Way Suite 100, Idaho Falls ID 83404-7531. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Jenkins, Shannon can be contacted via phone (208) 535-4575.

Contact Information

Primary practice address
2860 Channing Way Suite 100 Idaho Falls ID 83404-7531
Phone: (208) 535-4575
Fax: (208) 535-4569
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 3863 Arizona
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X O0424 Idaho

Profile Details

NPI number 1023083680
LBN Legal business name Jenkins, Shannon
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Dec 23rd, 2008 - about 16 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 1023083680 NPPES
Montana MEDICAID 0117377
Montana MEDICAID 121542600
Montana MEDICAID 121542600
Montana MEDICAID 1285786046

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