Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 7606 | KY |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 774 | KY |
NPI | 1437177722 |
---|---|
Provider Name | Dr. William Scott Jenkins |
First Address | Lexington, KY 40502 |
Second Address | Lexington, KY 40509-1888 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 09/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
60003928 | (05) | KY |
64120793 | (05) | KY |