Healthcare Provider Details

I. General information

NPI: 1487674016
Provider Name (Legal Business Name): HAL JEFFERSON JENKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 MILLERS LANDING BLVD
MORRISTOWN TN
37813-2181
US

IV. Provider business mailing address

179 MILLERS LANDING BLVD
MORRISTOWN TN
37813-2181
US

V. Phone/Fax

Practice location:
  • Phone: 423-254-6770
  • Fax: 423-977-7115
Mailing address:
  • Phone: 423-254-6770
  • Fax: 423-977-7115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD37158
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: