Provider Demographics
NPI:1396967634
Name:JENKINS MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:JENKINS MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:DYE
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-964-9600
Mailing Address - Street 1:5509 PLEASANT VALLEY DR
Mailing Address - Street 2:SUITE 20
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5248
Mailing Address - Country:US
Mailing Address - Phone:972-964-9600
Mailing Address - Fax:972-964-6611
Practice Address - Street 1:5509 PLEASANT VALLEY DR
Practice Address - Street 2:SUITE 20
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5248
Practice Address - Country:US
Practice Address - Phone:972-964-9600
Practice Address - Fax:972-964-6611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty