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General NPI Number Information
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NPI Number | 1023031374
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Entity Type | Organization
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Legal Business Name | SUZANNE JENKINS DPM
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 904 CORSICANA HWY
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City | HILLSBORO
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State | TX
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Zip | 76645-2928
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Country | US
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Telephone | 254-582-9300
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Fax | 254-582-9302
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Provider Business Mailing Address
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Address Line | 904 CORSICANA HWY
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City | HILLSBORO
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State | TX
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Zip | 76645-2928
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Country | US
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Telephone | 254-582-9300
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Fax | 254-582-9302
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUZANNE RENE JENKINS
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Credential | DPM
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Telephone | 245-582-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 1774
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License Number State | TX
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