Provider Demographics
NPI:1215627005
Name:JENKINS, DYLAN JOSEPH (PA-C)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:JOSEPH
Last Name:JENKINS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3002 CHAPEL HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-7990
Mailing Address - Country:US
Mailing Address - Phone:615-617-0985
Mailing Address - Fax:
Practice Address - Street 1:2860 RONALD REAGAN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6092
Practice Address - Country:US
Practice Address - Phone:404-256-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant