Healthcare Provider Details

I. General information

NPI: 1689962649
Provider Name (Legal Business Name): JENKINS & MORROW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CITY HILL DR SUITE 102
LONDON KY
40741-3038
US

IV. Provider business mailing address

200 CITY HILL DR SUITE 102
LONDON KY
40741-3038
US

V. Phone/Fax

Practice location:
  • Phone: 859-264-1898
  • Fax:
Mailing address:
  • Phone: 859-264-1898
  • Fax: 859-685-0118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: STEFANIE BARNETT
Title or Position: INS COORDINATOR
Credential:
Phone: 859-264-1898