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Individual
DR. MATTHEW T JENNINGS
Active
Individual
DR. MATTHEW T JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0768
AL
207LP2900X
Pain Medicine (Anesthesiology) Physician
D0768
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009994565
—
AL
01
—
018824088A
GEORGIA MEDICAID
—
01
—
51528444
BCBS OF AL
—
Enumeration date
01/10/2006
Last updated
04/25/2011
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