Provider Demographics
NPI:1437673951
Name:JENKINS, ANTHONY LEONARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:LEONARD
Last Name:JENKINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9510 ELLERBE RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-7406
Mailing Address - Country:US
Mailing Address - Phone:318-797-3272
Mailing Address - Fax:318-797-3202
Practice Address - Street 1:9510 ELLERBE RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-7406
Practice Address - Country:US
Practice Address - Phone:318-797-3272
Practice Address - Fax:318-797-3202
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.022070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA002307OtherMEDICATION ADMINISTRATION