MEDICARE: KIMBLEY JENKINS

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	343900000X	Non-emergency Medical Transport (VAN)		MS

General Provider Information

NPI Number	:	1346071982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBLEY JENKINS

Provider Business Mailing Address
First Line	:	3707 KNOX RD
Second Line	:
City	:	TOOMSUBA
State	:	MS
Zip	:	39364-9576
Country	:	US
Telephone Number	:	601-745-5777
Fax Number	:

Provider Business Practice Location Address
First Line	:	3707 KNOX RD
Second Line	:
City	:	TOOMSUBA
State	:	MS
Zip	:	39364-9576
Country	:	US
Telephone Number	:	601-745-5777
Fax Number	:

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

Provider Enumeration Date	:	08/13/2024
Last Update Date	:	08/13/2024

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Directions to “ KIMBLEY JENKINS ” Practice Location

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