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Individual

DR. JACKIE WAYNE TENNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6400 PROSPECT AVE, SUITE 646, KANSAS CITY, MO 64132-1100
(816) 444-8400
(816) 444-8407
Mailing address
6501 E 87TH ST, KANSAS CITY, MO 64138-2732
(816) 444-8400
(816) 444-8407

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R7F09
MO

Other

Enumeration date
06/10/2006
Last updated
06/19/2012
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