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General NPI Number Information
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NPI Number | 1053811653
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Entity Type | Individual
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Provider Name | JENNIFER UNDERHILL MD
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | NMRTC OKINAWA DEPARTMENT OF GENERAL SURGERY
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City | CAMP FOSTER
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State | OKINAWA
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Zip | 96362
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Country | JP
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Telephone | 98-971-7148
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 482
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City | FPO
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State | AP
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Zip | 96362-1600
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101270283
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License Number State | VA
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