Jenkins, Brad R

Jenkins, Brad R is an individual health care provider with primary practice located at 1115 S Main St , Fort Scott KS 66701-2651. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Jenkins, Brad R can be contacted via phone (620) 223-4448.

Contact Information

Primary practice address
1115 S Main St Fort Scott KS 66701-2651
Phone: (620) 223-4448
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X KS 7195 Kansas

Profile Details

NPI number 1295873727
LBN Legal business name Jenkins, Brad R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jan 30th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295873727 NPPES
Kansas MEDICAID 100350890E

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