Provider Demographics
NPI:1437285491
Name:JENKS, DONALD E (OD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:JENKS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 BERNADETTE DR
Mailing Address - Street 2:PO BOX 30671
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4607
Mailing Address - Country:US
Mailing Address - Phone:573-657-6106
Mailing Address - Fax:
Practice Address - Street 1:2201 W WORLEY ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-1055
Practice Address - Country:US
Practice Address - Phone:573-657-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO1986152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist