Individual
DR. JENNIFER A. MOZINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
990 OAK RIDGE TPKE, OAK RIDGE, TN 37830-6976
(865) 481-1000
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
38716
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3897723
—
TN
05
—
3897724
—
TN
01
—
4088255
BLUE CROSS
TN
01
—
4107831
BLUE CROSS
TN
01
—
P00231577
RRGA
TN
01
—
P00317398
RAILROAD MEDICARE
TN
Enumeration date
06/08/2006
Last updated
11/29/2007
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