Provider Demographics
NPI:1245299551
Name:JENNINGS, RICHARD HUNTER III (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HUNTER
Last Name:JENNINGS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:721 GLENWOOD DR STE 560
Mailing Address - Street 2:MEMORIAL MEDICAL BUILDING WEST
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1129
Mailing Address - Country:US
Mailing Address - Phone:423-622-2494
Mailing Address - Fax:423-622-4532
Practice Address - Street 1:721 GLENWOOD DR STE 560
Practice Address - Street 2:MEMORIAL MEDICAL BUILDING WEST
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1129
Practice Address - Country:US
Practice Address - Phone:423-622-2494
Practice Address - Fax:423-622-4532
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2011-12-28
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Provider Licenses
StateLicense IDTaxonomies
TN18857208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D40263Medicare UPIN
TN3049770Medicare PIN