Provider Demographics
NPI:1093025652
Name:SOUTHWEST KNEE & SHOULDER CENTER, PLLC.
Entity Type:Organization
Organization Name:SOUTHWEST KNEE & SHOULDER CENTER, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-492-4441
Mailing Address - Street 1:7796 US HIGHWAY 277 STE D
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OK
Mailing Address - Zip Code:73538-2131
Mailing Address - Country:US
Mailing Address - Phone:580-492-4441
Mailing Address - Fax:
Practice Address - Street 1:7796 US HIGHWAY 277
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:OK
Practice Address - Zip Code:73538-2131
Practice Address - Country:US
Practice Address - Phone:580-492-4441
Practice Address - Fax:580-492-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3998111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty