Jennings, Mark Randall
Jennings, Mark Randall is an individual health care provider with primary practice located at 2015 Jackson St , Anderson IN 46016-4337. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Jennings, Mark Randall can be contacted via phone (765) 649-2511.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01037730 | Indiana |
Profile Details
| NPI number | 1003915539 |
|---|---|
| LBN Legal business name | Jennings, Mark Randall |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2006 |
| Last updated | Mar 31st, 2015 - about 9 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 | 1003915539 | NPPES |
| Indiana | MEDICAID | 100172700 |
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