Individual
CHARLES A JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 LEXINGTON AVE, FORT SMITH, AR 72901-5136
(479) 709-7260
(479) 709-7261
Mailing address
PO BOX 402319, ATLANTA, GA 30384-2319
(479) 709-7399
(479) 709-7053
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N6962
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110985001
—
AR
05
—
200045210A
—
OK
Enumeration date
10/06/2005
Last updated
09/16/2010
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