Provider Demographics
NPI:1346201316
Name:JENKINS, JULIA C (DO)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:C
Last Name:JENKINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:CLAIRE
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:827 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-1666
Mailing Address - Country:US
Mailing Address - Phone:641-342-2128
Mailing Address - Fax:641-342-3179
Practice Address - Street 1:827 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1666
Practice Address - Country:US
Practice Address - Phone:641-342-2128
Practice Address - Fax:641-342-3179
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3581207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5452797Medicaid
IA1346201316Medicaid
IAP00360611OtherRR MEDICARE
IAI23958Medicare UPIN
IAP00360611OtherRR MEDICARE