Individual
JONATHAN TERRY JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4088 N HIGHWAY 91, HYDE PARK, UT 84318
(435) 563-4888
Mailing address
PO BOX 27128, SLC, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5525757-1205
UT
Other
Enumeration date
06/18/2012
Last updated
08/02/2021
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