Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0101235681 | VA |
NPI | 1225149750 |
---|---|
Provider Name | Torino R Jennings |
First Address | Mechanicsville, VA 23116-6683 |
Second Address | Mechanicsville, VA 23116-6683 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 15/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010034159 | VIRGINIA PREMIER (01) | VA |
10034159V | VIRGINIA COORDINATED (01) | VA |
1225149750 | (05) | VA |
174949 | ANTHEM BC BS (01) | VA |
44674 | CARENET (01) | VA |
73016 | OPTIMA HEALTH (01) | VA |
73016 | SENTARA (01) | VA |
75686 | SOUTHERN HEALTH (01) | VA |
I03900 | (02) | |
I03900 | (02) | VA |