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NPI Code Detail

MEDICARE: THOMAS G JENKO MD

MEDICARE: THOMAS G JENKO 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
1207Q00000XFamily Medicine Physician4682MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11851353965OTHERMTBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851353965
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS G JENKO MD
Provider Business Mailing Address
First Line : 8299 MT HWY 35
Second Line :
City : BIGFORK
State : MT
Zip : 59911
Country : US
Telephone Number : 406-837-5541
Fax Number : 406-837-5543
Provider Business Practice Location Address
First Line : 8299 MT HIGHWAY 35
Second Line :
City : BIGFORK
State : MT
Zip : 59911-3583
Country : US
Telephone Number : 406-837-5541
Fax Number : 406-837-5543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2006
Last Update Date : 04/16/2012

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