Organization
TRI-STATE VEIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH THOMAS JENKINS M.D. (OWNER)
(563) 583-8346
Entity
Organization
Contact information
Practice address
505 CEDAR CROSS RD, SUITE A, DUBUQUE, IA 52003-7704
(563) 583-8346
(563) 557-3710
Mailing address
505 CEDAR CROSS RD, SUITE A, DUBUQUE, IA 52003-7704
(563) 583-8346
(563) 557-3710
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
26573
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2069948
—
IA
05
—
32029700
—
WI
Enumeration date
01/19/2011
Last updated
02/24/2011
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