Healthcare Provider Details

I. General information

NPI: 1518955012
Provider Name (Legal Business Name): LEONARD EUGENE JENKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3516 WASHINGTON AVE
FINLEYVILLE PA
15332-1328
US

IV. Provider business mailing address

926 MORNINGSIDE AVE
PITTSBURGH PA
15206-1345
US

V. Phone/Fax

Practice location:
  • Phone: 724-348-7371
  • Fax: 724-348-6816
Mailing address:
  • Phone: 412-441-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD426471
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: