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General NPI Number Information
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NPI Number | 1508076753
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Entity Type | Individual
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Provider Name | DARREN B JENKINS D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 09/28/2016
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Provider Practice Location Address
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Address Line | 1561 W 7000 S SUITE 200
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City | WEST JORDAN
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State | UT
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Zip | 84084-3556
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Country | US
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Telephone | 801-562-5300
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Fax | 801-562-1883
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Provider Business Mailing Address
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Address Line | 6933 S 1300 W SUITE 200
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City | WEST JORDAN
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State | UT
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Zip | 84084-2554
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Country | US
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Telephone | 801-542-8080
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Fax | 801-748-0423
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | R1030
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7540742-1204
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5166
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License Number State | AZ
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