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2677 E 17th St Ste 200, Ammon, ID 83406-6612 | |
(208) 741-3660 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 2677 E 17th St Ste 200, Ammon, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1922736842 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Primary |
Provider Name | Braden Thomas Jenkins |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1609337682 PECOS PAC ID: 7719363266 Enrollment ID: I20221108001753 |
Mailing Address | Practice Location Address |
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2677 E 17th St Ste 200, Ammon, ID 83406-6612 Ph: (208) 741-3660 | 2677 E 17th St Ste 200, Ammon, ID 83406-6612 Ph: (208) 741-3660 |
Braden Jenkins, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 2677 E 17th St Ste 200, Ammon, ID 83406 Phone: 208-881-2100 |