Provider Demographics
NPI:1932577962
Name:JEFFREY P JENKS, MD PC
Entity Type:Organization
Organization Name:JEFFREY P JENKS, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:JENKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-244-1777
Mailing Address - Street 1:2955 PROFESSIONAL PL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-8139
Mailing Address - Country:US
Mailing Address - Phone:719-591-5545
Mailing Address - Fax:719-591-5540
Practice Address - Street 1:2955 PROFESSIONAL PL
Practice Address - Street 2:SUITE 201
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-8139
Practice Address - Country:US
Practice Address - Phone:719-591-5545
Practice Address - Fax:719-591-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty