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NPI Code Detail

MEDICARE: DR. JOSEPH DILLON JENKINS D.O.

MEDICARE: DR. JOSEPH DILLON JENKINS D.O.
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
1207Q00000XFamily Medicine Physician02003610AIN
2207Q00000XFamily Medicine PhysicianQ4145TX

General Provider Information

NPI Number : 1962655803
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH DILLON JENKINS D.O.
Provider Business Mailing Address
First Line : 1016 N VIRGINIA ST
Second Line :
City : PORT LAVACA
State : TX
Zip : 77979-3000
Country : US
Telephone Number : 361-552-0325
Fax Number : 361-500-6904
Provider Business Practice Location Address
First Line : 1016 N VIRGINIA ST
Second Line :
City : PORT LAVACA
State : TX
Zip : 77979-3000
Country : US
Telephone Number : 361-552-0325
Fax Number : 361-500-6904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2008
Last Update Date : 09/17/2024

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