Organization
FARWELL FAMILY MEDICINE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN DOUGLAS JENNINGS DO (PRESIDENT)
(989) 386-7982
Entity
Organization
Contact information
Practice address
10256 N WHITEVILLE RD, CLARE, MI 48617-9319
(989) 386-7982
(989) 386-4232
Mailing address
10256 N WHITEVILLE RD, CLARE, MI 48617-9319
(989) 386-7982
(989) 386-4232
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MJ007488
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417309
—
MI
Enumeration date
05/11/2009
Last updated
12/08/2009
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