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Individual

DR. EUGENE LESLIE JENNINGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
30-32 N MAIN ST, CARBONDALE, PA 18407-2304
(570) 242-2271
Mailing address
30-32 N MAIN ST, CARBONDALE, PA 18407-2304
(570) 242-2271

Taxonomy

Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
Primary
MD069938L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD069938L
LICENSE
PA
Enumeration date
05/21/2007
Last updated
03/28/2017
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