NPI 1043394562

Richard P. Jennings D.O. S. C.

Organisation Otolaryngology Physician Beaver Dam, WI

Practice location

Address: 109 Warren St, Beaver Dam, WI 53916
Phone: (920) 887-8646
Fax: (920) 887-8953
Mailing address: 109 Warren St Suite #1, Beaver Dam, WI 53916-3082

Authorised official

Name: Richard P Jennings
Title: Physician Owner
Phone: (920) 887-8646

Registered specialties

Otolaryngology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X Licence 29143 (WI)

Other Otolaryngology providers in Wisconsin →

Registry record

NPI: 1043394562
Entity type: Organization
NPI issued: 24 Oct 2006
Record last updated: 12 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.