Healthcare Provider Details

I. General information

NPI: 1548791130
Provider Name (Legal Business Name): JENNA PFLEEGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 GORDON SMITH DR
MOBILE AL
36617-2318
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-434-3475
  • Fax: 251-434-3837
Mailing address:
  • Phone: 866-401-3057
  • Fax: 318-868-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.37567
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: