MEDICARE: DR. MARK R JENNINGS 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
1	208600000X	Surgery Physician	35085981	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00274332	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1578538955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK R JENNINGS M.D.

Provider Business Mailing Address
First Line	:	3300 MERCY HEALTH BLVD STE 2010
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1103
Country	:	US
Telephone Number	:	513-961-4335
Fax Number	:	513-872-5769

Provider Business Practice Location Address
First Line	:	3300 MERCY HEALTH BLVD STE 2010
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1103
Country	:	US
Telephone Number	:	513-961-4335
Fax Number	:	513-872-5769

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	09/26/2019

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Directions to “ DR. MARK R JENNINGS M.D.” Practice Location

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