Organization
RICHARD P. JENNINGS D.O. S. C.
Active
Organization
RICHARD P. JENNINGS D.O. S. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD P JENNINGS DO (PHYSICIAN OWNER)
(920) 887-8646
Entity
Organization
Contact information
Practice address
109 WARREN ST, BEAVER DAM, WI 53916
(920) 887-8646
(920) 887-8953
Mailing address
109 WARREN ST, SUITE #1, BEAVER DAM, WI 53916-3082
(920) 887-8646
(920) 887-8953
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
29143
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30042200
—
WI
Enumeration date
10/24/2006
Last updated
06/12/2008
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