Individual
SHAUN F JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8726 US HIGHWAY 42, FLORENCE, KY 41042-9625
(859) 384-2660
(859) 384-5248
Mailing address
2300 CHAMBER CENTER DR, SUITE 200, LAKESIDE PARK, KY 41017-1686
(859) 384-2660
(859) 384-5248
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02882
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2600528
—
OH
05
—
64100167
—
KY
01
—
P00217671
RAILROAD MEDICARE
KY
01
—
P00873389
RAILROAD MEDICARE
KY
Enumeration date
06/09/2006
Last updated
09/24/2015
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