Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0941 | MS |
NPI | 1003963745 |
---|---|
Provider Name | Ronald Houston Jenkins |
First Address | Ocean Springs, MS 39566-1212 |
Second Address | Ocean Springs, MS 39564-3114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |