| Doctor Name: | DR. BRIAN DOUGLAS JENKINS |
| NPI Number: | 1497725295 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 5101015609 |
| Business Practice Address: | 1305 W American Dr Neenah, WI - 549561993 |
| Business Phone Number: | 8002011194 |
| Business Fax Number: | 9207207392 |
| Mailing Address: | 1305 W American Dr, NEENAH |
| State: | WI |
| Postal Code: | 549561993 |
| Phone Number: | 8002011194 |
| Fax Number: | 9207207392 |
| NPI Enumeration Date: | 01/24/2006 |
| NPI Last Update Date: | 03/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101015609 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |