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General NPI Number Information
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NPI Number | 1649363714
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Entity Type | Individual
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Provider Name | JENNIFER PRYOR MD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 1521 GULL RD
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City | KALAMAZOO
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State | MI
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Zip | 49048-1666
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Country | US
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Telephone | 269-226-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 3007 SANDHILL RD
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City | MASON
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State | MI
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Zip | 48854-9410
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Country | US
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Telephone | 570-995-1430
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 4301507905
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License Number State | MI
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