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NPI Code Detail

MEDICARE: MR. WILLIAM WESLEY JENNINGS III M.D.

MEDICARE: MR. WILLIAM WESLEY JENNINGS III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician39891CO
2207V00000XObstetrics & Gynecology Physician17694NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245280908
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM WESLEY JENNINGS III M.D.
Provider Business Mailing Address
First Line : 2345 E PRATER WAY STE 207
Second Line :
City : SPARKS
State : NV
Zip : 89434-9634
Country : US
Telephone Number : 775-356-4067
Fax Number : 702-333-8466
Provider Business Practice Location Address
First Line : 1050 W GALLERIA DR
Second Line :
City : HENDERSON
State : NV
Zip : 89011-4800
Country : US
Telephone Number : 702-963-7000
Fax Number : 702-333-8466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 04/11/2018

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