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NPI Code Detail

MEDICARE: WILEY J. JINKINS III M.D.

MEDICARE: WILEY J. JINKINS III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician30211CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033287396
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILEY J. JINKINS III M.D.
Provider Business Mailing Address
First Line : 2020 N ACADEMY BLVD
Second Line : SUITE 155
City : COLORADO SPRINGS
State : CO
Zip : 80909-1567
Country : US
Telephone Number : 719-219-0914
Fax Number : 719-219-0916
Provider Business Practice Location Address
First Line : 2020 N ACADEMY BLVD
Second Line : SUITE 155
City : COLORADO SPRINGS
State : CO
Zip : 80909-1567
Country : US
Telephone Number : 719-219-0914
Fax Number : 719-219-0916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2006
Last Update Date : 10/25/2007

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