Provider Demographics
NPI:1851062533
Name:JENKINS, DANIEL ROOSEVELT JR
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ROOSEVELT
Last Name:JENKINS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22296 ADAMS GROVE RD
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-6667
Mailing Address - Country:US
Mailing Address - Phone:434-632-9150
Mailing Address - Fax:
Practice Address - Street 1:22296 ADAMS GROVE RD
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-6667
Practice Address - Country:US
Practice Address - Phone:434-632-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)