Provider Demographics
NPI:1578805388
Name:JERKINS, EVIN G (DO)
Entity Type:Individual
Prefix:
First Name:EVIN
Middle Name:G
Last Name:JERKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 N EWING ST STE 204
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3378
Mailing Address - Country:US
Mailing Address - Phone:740-689-4925
Mailing Address - Fax:
Practice Address - Street 1:618 PLEASANTVILLE RD STE 303
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3373
Practice Address - Country:US
Practice Address - Phone:740-689-6833
Practice Address - Fax:740-689-6827
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34012843207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Multi-Specialty