Individual
LAURA AILEEN JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
(918) 426-1800
Mailing address
1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
(918) 426-1800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5576
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/14/2013
Last updated
07/26/2014
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