Provider Demographics
NPI:1003963745
Name:JENKINS, RONALD HOUSTON (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:HOUSTON
Last Name:JENKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1212
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39566-1212
Mailing Address - Country:US
Mailing Address - Phone:228-875-6943
Mailing Address - Fax:228-875-9682
Practice Address - Street 1:2429 W COMMERCE ST
Practice Address - Street 2:SUITE C
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3114
Practice Address - Country:US
Practice Address - Phone:228-875-6943
Practice Address - Fax:228-875-9682
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor