Individual
DR. MATTHEW BRADLEY JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
(479) 587-5915
Mailing address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
(479) 587-5915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-9048
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04515143
BCBS#
IL
Enumeration date
11/04/2005
Last updated
09/20/2023
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