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Individual

DR. WINSTON JENNINGS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
306 BEAMAN ST, CLINTON, NC 28328-2908
(910) 567-7107
Mailing address
182 FAISON W MCGOWAN RD, KENANSVILLE, NC 28349-8930
(910) 275-0369

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
38720
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0350883240
ME#
NC
01
327665
TRICARE
NC
01
45914
BCBS
NC
05
5900999
NC
01
E0093
MEDCOST
NC
Enumeration date
07/08/2006
Last updated
11/10/2011
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