Healthcare Provider Details

I. General information

NPI: 1922204536
Provider Name (Legal Business Name): DAVID CHRISTOPHER JENNINGS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE 4TH FLOOR REHABILITATION UNIT
TULSA OK
74136-1902
US

IV. Provider business mailing address

6600 S YALE AVE STE 1400
TULSA OK
74136-3331
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-4250
  • Fax: 918-494-4299
Mailing address:
  • Phone: 918-499-4855
  • Fax: 918-488-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number4593
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number4593
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: