| Mary Kathleen Jennings, MD | |
|
84 Marginal Way, Suite 1000, Portland, ME 04101-1392 | |
| (207) 774-4092 | |
| (207) 523-8596 |
| Full Name | Mary Kathleen Jennings |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 84 Marginal Way, Portland, Maine |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679741839 | NPI | - | NPPES |
| 30209656 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 016582 (Maine) | Primary |
| Entity Name | Intermed Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467422733 PECOS PAC ID: 5092605261 Enrollment ID: O20040319000548 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Kathleen Jennings, MD 100 Foden Rd, Suite 203, South Portland, ME 04106-2327 Ph: (207) 828-0361 | Mary Kathleen Jennings, MD 84 Marginal Way, Suite 1000, Portland, ME 04101-1392 Ph: (207) 774-4092 |
Rushika M Conroy, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 41 Donald B Dean Dr Ste A, Portland, ME 04106 Phone: 207-661-6064 | |
Michael Alexander Ferguson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 22 Bramhall St, Mmc Picu, Portland, ME 04102 Phone: 207-662-6711 | |
Dr. Rute S Rothwell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-7060 | |
Kenneth Lombard, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 887 Congress St, Suite 410b, Portland, ME 04102 Phone: 207-662-5522 Fax: 207-662-5526 | |
Gretchen A. Pianka, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 180 Park Ave Ste 1, Portland, ME 04102 Phone: 207-874-2141 Fax: 207-874-2164 | |
Webb E. Long, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 180 Park Ave Ste 1, Portland, ME 04102 Phone: 207-874-2141 Fax: 207-874-2164 | |
David F Cox, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2353 |