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General NPI Number Information
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NPI Number | 1164733051
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Entity Type | Organization
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Legal Business Name | DAVID W. JENKINS DPM
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 12/23/2010
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Provider Practice Location Address
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Address Line | 9377 E BELL RD SUITE 207
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-1502
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Country | US
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Telephone | 480-567-0239
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Fax | 480-567-0292
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Provider Business Mailing Address
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Address Line | 20165 N 67TH AVE 122-A-115
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City | GLENDALE
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State | AZ
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Zip | 85308-7002
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Country | US
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Telephone | 480-567-0239
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Fax | 480-567-0292
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. DAVID W. JENKINS
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Credential | DPM
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Telephone | 480-567-0239
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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 | 0618
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License Number State | AZ
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