Jenkins, Derek Randall

Jenkins, Derek Randall is an sole proprietor health care provider with primary practice located at 1 Kettle Point Ave , East Providence RI 02914-5375. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery is his primary health care specialty. Jenkins, Derek Randall can be contacted via phone (401) 453-9032.

Contact Information

Primary practice address
1 Kettle Point Ave East Providence RI 02914-5375
Phone: (401) 453-9032
Fax: (401) 861-5812
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 106300 Minnesota
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 55660 Minnesota
Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery 207XS0114X 16277 New Hampshire

Profile Details

NPI number 1669613907
LBN Legal business name Jenkins, Derek Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 17th, 2009
Last updated Feb 12th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669613907 NPPES
Minnesota MEDICAID ENROLLED
Minnesota MEDICAID ENROLLED

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