Individual
DR. TAWNYIA JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3527 W TRUMAN BLVD, JEFFERSON CITY, MO 65109-5901
(573) 882-8910
(573) 884-1585
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
118133
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126471
BLUE CROSS BLUE SHIELD
—
05
—
204642433
—
MO
01
—
2194853
FIRST HEALTH
—
01
—
2904972
CIGNA
—
01
—
410414
HEALTHLINK
—
01
—
440546366
UNITED HEALTH CARE
—
01
—
5512885
CCN
—
01
—
G69424
MERCY
—
01
—
P00134687
RR MEDICARE
—
Enumeration date
03/08/2006
Last updated
05/29/2024
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