Organization
TENNEY PEDIATRICS AND ADOLESCENTS MEDICINE LLC
Active
Other names
Tenney Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKIE WAYNE TENNEY M.D. (OWNER)
(816) 444-8400
Entity
Organization
Contact information
Practice address
6501 E 87TH ST, KANSAS CITY, MO 64138-2732
(816) 444-8400
(816) 444-8407
Mailing address
6501 E 87TH ST, KANSAS CITY, MO 64138-2732
(816) 444-8400
(816) 444-8407
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R7FO9
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202260527
—
MO
Enumeration date
05/12/2008
Last updated
10/28/2011
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