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NPI Code Detail

MEDICARE: CHESTER W JENKINS MD

MEDICARE: CHESTER W JENKINS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianN8305AR
22084P0800XPsychiatry Physician15598MS
32084P0800XPsychiatry PhysicianMD0000029544TN
42084P0800XPsychiatry Physician00005814AL
52084P0800XPsychiatry Physician012716GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184622201
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHESTER W JENKINS MD
Provider Business Mailing Address
First Line : PO BOX 4739
Second Line :
City : GREENVILLE
State : MS
Zip : 38704-4739
Country : US
Telephone Number : 662-725-2749
Fax Number : 662-725-2741
Provider Business Practice Location Address
First Line : 300 S WASHINGTON AVE
Second Line :
City : GREENVILLE
State : MS
Zip : 38701-4719
Country : US
Telephone Number : 662-725-1025
Fax Number : 662-725-1023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 10/24/2011

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Directions to “ CHESTER W JENKINS MD” Practice Location

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