Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 32593 | OK |
N | 207VX0201X | Gynecologic Oncologist | L4470 | TX |
N | 2086X0206X | Surgical Oncologist | 058970 | GA |
NPI | 1487686200 |
---|---|
Provider Name | Dr. Alfred D Jenkins |
First Address | Tulsa, OK 74146-6236 |
Second Address | Tulsa, OK 74146-6236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 24/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200674540A | (05) | OK |
288841401 | (05) | TX |
288841402 | (05) | TX |
365304ZSS0 | (02) | OK |
8DB701 | BCBS (01) | TX |
P01096120 | RAILROAD MEDICAR (01) | TX |
TXB145474 | (02) | TX |