Individual
TIMOTHY DOUGLAS JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2410 SUSANNAH STREET, JOHNSON CITY, TN 37601
(423) 282-9011
(423) 282-0035
Mailing address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1765
(423) 282-9011
(423) 282-0035
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD0000043343
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1505390
—
TN
Enumeration date
05/24/2007
Last updated
12/16/2019
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