Individual
BRADEN JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2677 E 17TH ST STE 200, AMMON, ID 83406-6612
(208) 881-2100
Mailing address
2677 E 17TH ST STE 200, AMMON, ID 83406-6612
(208) 741-3660
(208) 741-3709
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
NA
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
NA
UT
213ES0131X
Foot Surgery Podiatrist
NA
UT
Other
Enumeration date
03/30/2019
Last updated
01/29/2025
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