Dallas, Jennifer Lauren
Dallas, Jennifer Lauren is an individual health care provider with primary practice located at 2711 Randolph Rd Ste 400 , Charlotte NC 28207-2027. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Medical Oncology, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is her primary health care specialty. Dallas, Jennifer Lauren can be contacted via phone (707) 342-9577.Contact Information
Primary practice address
2711 Randolph Rd Ste 400
Charlotte NC 28207-2027
Phone: (707) 342-9577
Fax: (704) 377-0353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 201500282 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 066472 | Georgia |
| Allopathic & Osteopathic Physicians / Hematology | 207RH0000X | 066472 | Georgia |
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | 066472 | Georgia |
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | 201500282 | North Carolina |
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 201500282 | North Carolina |
Profile Details
| NPI number | 1417046343 |
|---|---|
| LBN Legal business name | Dallas, Jennifer Lauren |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Nov 18th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417046343 | NPPES |
| Georgia | MEDICAID | 003114517A |
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