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General NPI Number Information
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NPI Number | 1386024800
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Entity Type | Individual
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Provider Name | BRIAN JOSEPH JENNINGS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 210 W 1ST ST
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City | SAINT FRANCIS
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State | KS
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Zip | 67756-3540
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Country | US
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Telephone | 785-332-2104
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Fax | 785-332-3255
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Provider Business Mailing Address
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Address Line | 180 FORD RD
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City | JOHN DAY
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State | OR
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Zip | 97845-2009
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Country | US
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Telephone | 541-575-0404
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Fax | 541-575-1124
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-41177
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TL0005731
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD201060
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License Number State | OR
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