Healthcare Provider Details

I. General information

NPI: 1265420400
Provider Name (Legal Business Name): JAMES EMERSON JENKS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 MCKENZIE POND RD
SARANAC LAKE NY
12983-2560
US

IV. Provider business mailing address

729 MCKENZIE POND RD
SARANAC LAKE NY
12983-2560
US

V. Phone/Fax

Practice location:
  • Phone: 518-275-9251
  • Fax:
Mailing address:
  • Phone: 518-275-9151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number138704
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: