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Individual

DR. DAVID JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
12 SMITH AVE, GREENVILLE, RI 02828-1767
(401) 949-1616
(401) 942-0952
Mailing address
19 CARONIA ST, CRANSTON, RI 02920-4333
(401) 450-5263
(401) 942-1783

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
4390
MA
152W00000X
Optometrist
Primary
ODTA00508
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0700215
MA
01
4390
TPA OPTOMETRY LICENSE #
MA
01
469916
TUFTS PROVIDER #
MA
01
AA15972
HARVARD PILGRIM
MA
01
W16381
BCBS MA
MA
Enumeration date
06/13/2005
Last updated
10/15/2024
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