Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DEREK RANDALL JENKINS, M.D.
Active Sole ProprietorDEREK RANDALL JENKINS, M.D. is a Sports Medicine (Orthopaedic) healthcare provider located in EAST PROVIDENCE, Rhode Island. NPI 1669613907 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (Orthopaedic) · EAST PROVIDENCE, RI
Registration Details
- NPI Number
- 1669613907
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 17, 2009 (17.426637208034 yrs)
- Last Updated
- Feb 12, 2019
- Licenses
-
106300 (MN)55660 (MN)16277 (NH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 KETTLE POINT AVEEAST PROVIDENCE, RI, 029145375Browse RI providers · Browse ZIP 02914
- Phone
- 4014539032
- Fax
- 4018615812
- Primary Specialty
-
Sports Medicine (Orthopaedic)
207XS0114X
- Additional Specialty
- Orthopaedic Surgery
- Additional Specialty
- Sports Medicine (Orthopaedic)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.