MEDICARE: MORGAN JENKINS 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
1	208000000X	Pediatrics Physician	G57608	CA
2	208D00000X	General Practice Physician	ME129312	FL
3	208D00000X	General Practice Physician	G57608	CA
4	208000000X	Pediatrics Physician	ME129312	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1124194980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN JENKINS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 191
Second Line	:	PROVIDER ENROLLMENT DEPARTMENT
City	:	ROCKLAND
State	:	DE
Zip	:	19732-0191
Country	:	US
Telephone Number	:	302-651-6212
Fax Number	:	302-651-4945

Provider Business Practice Location Address
First Line	:	16709 KAMALIN CT
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34715-9519
Country	:	US
Telephone Number	:	352-989-0576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	03/21/2018

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