Individual
DR. RICHARD B. JENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R4C31
MO
207RG0100X
Gastroenterology Physician
Primary
R4C31
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110042201
MEDICARE RAILROAD
MO
05
—
202614905
—
MO
01
—
CP9089
RAILROAD GROUP
MO
Enumeration date
12/07/2005
Last updated
01/14/2014
Update your record
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