Jennings, Alicia M
Jennings, Alicia M is an individual health care provider with primary practice located at 101 Quartz Drive Suite 201, Villa Rica GA 30180. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Jennings, Alicia M can be contacted via phone (770) 456-3839.Contact Information
Primary practice address
101 Quartz Drive Suite 201
Villa Rica GA 30180
Phone: (770) 456-3839
Fax: (770) 456-3846
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 061901 | Georgia |
Profile Details
| NPI number | 1366405037 |
|---|---|
| LBN Legal business name | Jennings, Alicia M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2006 |
| Last updated | Jul 21st, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366405037 | NPPES |
| Georgia | MEDICAID | 673576429C |
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