Provider Demographics
NPI:1548339989
Name:JONKERS, JENNIFER A (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:JONKERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 EAST VALLEY STREET
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210
Mailing Address - Country:US
Mailing Address - Phone:276-628-1106
Mailing Address - Fax:276-676-0215
Practice Address - Street 1:322 EAST VALLEY STREET
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210
Practice Address - Country:US
Practice Address - Phone:276-628-1106
Practice Address - Fax:276-676-0215
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233814207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010156289Medicaid
VA010156289Medicaid
VA004898R77Medicare ID - Type Unspecified