MEDICARE: PHILIP ROSS JENKINS DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	401	NC

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	:	1841277662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP ROSS JENKINS DPM

Provider Business Mailing Address
First Line	:	401 MULBERRY ST SW STE 102
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-5463
Country	:	US
Telephone Number	:	828-757-6434
Fax Number	:	828-757-6435

Provider Business Practice Location Address
First Line	:	401 MULBERRY ST SW STE 102
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-5463
Country	:	US
Telephone Number	:	828-757-6434
Fax Number	:	828-757-6435

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	03/19/2021

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Directions to “ PHILIP ROSS JENKINS DPM” Practice Location

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