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General NPI Number Information
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NPI Number | 1558403857
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Entity Type | Organization
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Legal Business Name | REBECCA JENKINS DO PLC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 5 N FEDERAL AVE STE 104
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City | MASON CITY
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State | IA
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Zip | 50401-3270
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Country | US
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Telephone | 641-494-2404
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Fax |
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Provider Business Mailing Address
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Address Line | 5 N FEDERAL AVE STE 104
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City | MASON CITY
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State | IA
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Zip | 50401-3270
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Country | US
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Telephone | 641-494-2404
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. REBECCA JENKINS
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Credential | DO
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Telephone | 641-494-2404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02933
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License Number State | IA
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