Individual
DR. RUSSELL W JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-4170
Mailing address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-4170
(727) 767-4346
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
79209
MA
2086S0120X
Pediatric Surgery Physician
79209
MA
2086S0120X
Pediatric Surgery Physician
Primary
ME153478
FL
Other
Enumeration date
07/18/2006
Last updated
01/27/2022
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