Individual
DR. ALICIA M JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 QUARTZ DRIVE, SUITE 201, VILLA RICA, GA 30180
(770) 456-3839
(770) 456-3846
Mailing address
119 AMBULANCE DR STE 202, CARROLLTON, GA 30117-3857
(770) 838-8710
(770) 838-8563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
061901
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
673576429C
—
GA
Enumeration date
04/11/2006
Last updated
07/21/2022
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