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NPI Code Detail

MEDICARE: JENNIE M HUNNEWELL MD PLLC

MEDICARE: JENNIE M HUNNEWELL MD PLLC
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
1208D00000XGeneral Practice Physician20314OK

General Provider Information

NPI Number : 1487106431
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIE M HUNNEWELL MD PLLC
Provider Business Mailing Address
First Line : 5709 ROSEBAY CT
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-1812
Country : US
Telephone Number : 405-463-5700
Fax Number :
Provider Business Practice Location Address
First Line : 5101 W MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-2018
Country : US
Telephone Number : 405-463-5700
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. JENNIE M HUNNEWELL
Credential : MD
Telephone Number : 405-409-8369
Provider Enumeration Date : 10/25/2016
Last Update Date : 09/29/2023

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