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Individual

JOHN JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6051 HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-7000
Mailing address
410 THORNGATE DR, BRANDON, MS 39042-2334

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11044
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06108051
MS
05
1325180
LA
01
P00774929
RAILROAD MCARE THRU IHS
MS
01
P00833979
RAILROAD MCARE THRU HCCN
MS
Enumeration date
06/29/2006
Last updated
09/01/2010
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