Provider Demographics
NPI:1992200554
Name:JENKINS, HAROLD DOUGLAS (RRT-ACCS)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:DOUGLAS
Last Name:JENKINS
Suffix:
Gender:M
Credentials:RRT-ACCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 N TULSA DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-1328
Mailing Address - Country:US
Mailing Address - Phone:209-735-1718
Mailing Address - Fax:
Practice Address - Street 1:3012 N TULSA DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-1328
Practice Address - Country:US
Practice Address - Phone:209-735-1718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308102279C0205X
OK39842279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care