Individual
JONATHAN KELSIE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 ROSS CLARK CIR, DOTHAN, AL 36301-4754
(334) 793-2663
(334) 836-2247
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-2247
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2014-00264
NC
207X00000X
Orthopaedic Surgery Physician
Primary
MD.30641
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175185
—
AL
05
—
175468
—
AL
Enumeration date
05/19/2009
Last updated
09/24/2015
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