Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | E-11551 | AR |
N | 111NI0900X | Internist | E-11551 | AR |
Y | 207RI0200X | Infectious Disease | E-11551 | AR |
NPI | 1093100422 |
---|---|
Provider Name | Dr. Mitchell B Jenkins |
First Address | Little Rock, AR 72205-7101 |
Second Address | Little Rock, AR 72205-7101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2015 |
Last Update Date | 24/02/2021 |