| Clark L. Jennings, M.d., Inc | |
|
1414 N Nevada Ave Colorado Springs CO 80907-7431 | |
| (719) 475-8038 | |
| (719) 475-0993 |
| Full Name | Clark L. Jennings, M.d., Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1414 N Nevada Ave, Colorado Springs, Colorado |
| Authorized Official Name and Position | Clark L. Jennings (PRESIDENT) |
| Authorized Official Contact | 7194758038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark L. Jennings, M.d., Inc 1414 N Nevada Ave Colorado Springs CO 80907-7431 Ph: (719) 475-8038 | Clark L. Jennings, M.d., Inc 1414 N Nevada Ave Colorado Springs CO 80907-7431 Ph: (719) 475-8038 |
| NPI Number | 1508055906 |
|---|---|
| Provider Enumeration Date | 10/22/2007 |
| Last Update Date | 10/22/2007 |
| Medicare PECOS PAC ID | 4082704234 |
|---|---|
| Medicare Enrollment ID | O20071212000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508055906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 30385 (Colorado) | Primary |
| Provider Name | Clark L Jennings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760452908 PECOS PAC ID: 4183714330 Enrollment ID: I20071212000382 |
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