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General NPI Number Information
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NPI Number | 1497917645
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Entity Type | Individual
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Provider Name | DAVID C JENNINGS MD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 231 E CHESTNUT ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1821
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Country | US
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Telephone | 502-629-7661
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Fax | 502-629-5309
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 25-889-4905
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Fax | 502-272-5116
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 49536
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License Number State | KY
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