Jennings, John Alexander

Jennings, John Alexander is an individual health care provider with primary practice located at 6815 118Th Ave , Kenosha WI 53142-8420. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jennings, John Alexander can be contacted via phone (262) 857-5600.

Contact Information

Primary practice address
6815 118Th Ave Kenosha WI 53142-8420
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3312 Wisconsin

Profile Details

NPI number 1457798738
LBN Legal business name Jennings, John Alexander
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2013
Last updated Mar 2nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457798738 NPPES
Wisconsin Other 100031400 MEDICAID LEGACY NUMBER
Wisconsin MEDICAID 100031400 MEDICAID LEGACY NUMBER

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