Healthcare Provider Details

I. General information

NPI: 1023028461
Provider Name (Legal Business Name): OSCAR HUNT JERKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 ORANGE AVE
ROCKLEDGE FL
32955-2945
US

IV. Provider business mailing address

9 ORANGE AVE
ROCKLEDGE FL
32955
US

V. Phone/Fax

Practice location:
  • Phone: 888-974-5556
  • Fax: 888-974-5557
Mailing address:
  • Phone: 888-974-5556
  • Fax: 888-974-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME0078606
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: