Provider Demographics
NPI:1114928512
Name:JUNKINS, JASON C (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:C
Last Name:JUNKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W GRAND AVE
Mailing Address - Street 2:STE 90
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-3275
Mailing Address - Country:US
Mailing Address - Phone:256-459-4987
Mailing Address - Fax:256-459-4980
Practice Address - Street 1:115 W GRAND AVE
Practice Address - Street 2:STE 90
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-3275
Practice Address - Country:US
Practice Address - Phone:256-459-4987
Practice Address - Fax:256-459-4980
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21962207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51523075OtherBLUECROSS/BLUE SHIELD
AL51523075OtherBLUECROSS/BLUE SHIELD
AL000023075Medicare ID - Type UnspecifiedMEDICARE