Fennel, Jack

Fennel, Jack is an individual health care provider with primary practice located at 126 Missouri Ave , Fort Leonard Wood MO 65473-8952. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Adult Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Fennel, Jack can be contacted via phone (573) 329-8305.

Contact Information

Primary practice address
126 Missouri Ave Fort Leonard Wood MO 65473-8952
Phone: (573) 329-8305
Fax: (573) 329-8302
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X R9D28 Missouri
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X R9D28 Missouri

Profile Details

NPI number 1356300271
LBN Legal business name Fennel, Jack
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

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.

Request for update

Popular Providers