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Individual
TYRIE LEE JENKINS
Active
Individual
TYRIE LEE JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD5046
HI
207W00000X
Ophthalmology Physician
Primary
MD5046
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056891-01
—
HI
Enumeration date
04/25/2006
Last updated
02/03/2017
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