Organization
STEPHEN S JENNINGS OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN SELPH JENNINGS O.D. (SOLE MANGER, PRESIDENT, SECRETARY)
(804) 262-5142
Entity
Organization
Contact information
Practice address
2301 HILLIARD RD, SUITE 3, RICHMOND, VA 23228-4525
(804) 262-5142
(804) 262-6257
Mailing address
2301 HILLIARD RD, SUITE 3, RICHMOND, VA 23228-4525
(804) 262-5142
(804) 262-6257
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010300258
—
VA
05
—
010300274
—
VA
01
—
194180
ANTHEM 2ND OFFICE
VA
01
—
194188
ANTHEM PRIMARY OFFICE
VA
01
—
2146813
UNITED HEALTHCARE
VA
01
—
271018
MAMSI,OPTIMUM CH.,ALLIAN
VA
Enumeration date
08/13/2006
Last updated
02/23/2010
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