Basic Information
| Provider Information | |||||||||
| NPI: | 1114292588 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JENNINGS | ||||||||
| FirstName: | MARCUS | ||||||||
| MiddleName: | DARRELL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, MSPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 224D CORNWALL ST NW STE 403 | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201762704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037376010 | ||||||||
| FaxNumber: | 5712919786 | ||||||||
| Practice Location | |||||||||
| Address1: | 19441 GOLF VISTA PLAZA SUITE 230 & 310 | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201768272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037293420 | ||||||||
| FaxNumber: | 7037293422 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2012 | ||||||||
| LastUpdateDate: | 09/16/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD049407 | DC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | D0092220 | MD | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS1201X | MD049407 | DC | N | Allopathic & Osteopathic Physicians | Family Medicine | Sleep Medicine | 207Q00000X | 0101274037 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.