Jenkins, Randall D.

Jenkins, Randall D. is an individual health care provider with primary practice located at 100 E Idaho St Suite 304, Boise ID 83712. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Nephrology, which is considered as his primary health care specialty. Jenkins, Randall D. can be contacted via phone (208) 381-7336.

Contact Information

Primary practice address
100 E Idaho St Suite 304 Boise ID 83712
Phone: (208) 381-7336
Fax: (208) 381-7029
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X 12771 Oregon
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X M-6953 Idaho

Profile Details

NPI number 1619934213
LBN Legal business name Jenkins, Randall D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Jan 29th, 2016 - about 9 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1619934213 NPPES
Idaho MEDICAID 00340150
Idaho MEDICAID 270819
Idaho MEDICAID 8518003
Idaho MEDICAID XPY 190107
Idaho MEDICAID MD7720R

Popular Providers