Provider Demographics
NPI:1538381371
Name:JINKS, JOHN M (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:JINKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 MARTIN ST N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-1321
Mailing Address - Country:US
Mailing Address - Phone:205-338-6655
Mailing Address - Fax:205-338-6658
Practice Address - Street 1:613 MARTIN ST N
Practice Address - Street 2:SUITE 300
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-1321
Practice Address - Country:US
Practice Address - Phone:205-338-6655
Practice Address - Fax:205-338-6658
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00019183207L00000X
AL19183207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051550607Medicaid
AL51550607OtherBCBS
AL000038342Medicaid
AL51038342OtherBCBS
AL111219Medicaid
F86158Medicare UPIN
AL000038342Medicare PIN
AL102I055509Medicare PIN
AL111219Medicaid