Provider Demographics
NPI:1528357480
Name:JENKS, CHRISTOPHER SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:JENKS
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 1:131 W MARKET ST
Mailing Address - Street 2:STE B
Mailing Address - City:OSAGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66523-1000
Mailing Address - Country:US
Mailing Address - Phone:785-528-3161
Mailing Address - Fax:785-528-4045
Practice Address - Street 1:131 W MARKET ST
Practice Address - Street 2:STE B
Practice Address - City:OSAGE CITY
Practice Address - State:KS
Practice Address - Zip Code:66523-1000
Practice Address - Country:US
Practice Address - Phone:785-528-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0436022207QS0010X
KS04-36022207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200970230BMedicaid
KS068002199OtherMEDICARE PTAN