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NPI Code Detail

MEDICARE: DR. JENNIE M HUNNEWELL M.D. P.L.L.C.

MEDICARE: DR. JENNIE M HUNNEWELL M.D. P.L.L.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician20314OK
2208D00000XGeneral Practice Physician20314OK

General Provider Information

NPI Number : 1548244387
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIE M HUNNEWELL M.D. P.L.L.C.
Provider Business Mailing Address
First Line : 5025 GAILLARDIA CORPORATE PL
Second Line : SUITE C
City : OKLAHOMA CITY
State : OK
Zip : 73142-1888
Country : US
Telephone Number : 405-463-5700
Fax Number : 405-463-5705
Provider Business Practice Location Address
First Line : 5101 W MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-2018
Country : US
Telephone Number : 405-463-5700
Fax Number : 405-463-5705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 09/29/2023

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