Individual
DR. LAWRENCE P JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1430 COLLEGE DR, SUITE A, MOUNT CARMEL, IL 62863-2649
(618) 262-5113
Mailing address
1430 COLLEGE DR, SUITE A, MOUNT CARMEL, IL 62863-2649
(618) 262-5113
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036063272
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036063272
—
IL
05
—
200769096001
—
IL
01
—
P00169369
MEDICARE RAILROAD
IL
Enumeration date
12/30/2005
Last updated
04/29/2014
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