Provider Demographics
NPI:1487783908
Name:JINKS, JAMES R (CRNA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:JINKS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:119 AMBULANCE DRIVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117
Mailing Address - Country:US
Mailing Address - Phone:770-836-9666
Mailing Address - Fax:770-838-8563
Practice Address - Street 1:705 DIXIE ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3818
Practice Address - Country:US
Practice Address - Phone:770-836-9666
Practice Address - Fax:770-838-8563
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAR090653207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA43ZCBNK09Medicare ID - Type Unspecified