Provider Demographics
NPI:1508076753
Name:JENKINS, DARREN B (DO)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:B
Last Name:JENKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6933 S 1300 W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-2554
Mailing Address - Country:US
Mailing Address - Phone:801-542-8080
Mailing Address - Fax:801-748-0423
Practice Address - Street 1:1561 W 7000 S
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-3556
Practice Address - Country:US
Practice Address - Phone:801-562-5300
Practice Address - Fax:801-562-1883
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR1030390200000X
UT7540742-1204207Q00000X
AZ5166207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000069624Medicare UPIN