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General NPI Number Information
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NPI Number | 1184622201
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Entity Type | Individual
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Provider Name | CHESTER W JENKINS MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 300 S WASHINGTON AVE
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City | GREENVILLE
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State | MS
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Zip | 38701-4719
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Country | US
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Telephone | 662-725-1025
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Fax | 662-725-1023
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Provider Business Mailing Address
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Address Line | PO BOX 4739
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City | GREENVILLE
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State | MS
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Zip | 38704-4739
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Country | US
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Telephone | 662-725-2749
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Fax | 662-725-2741
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | N8305
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 15598
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD0000029544
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00005814
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 012716
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License Number State | GA
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