Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK FENNEL, DO
ActiveJACK FENNEL, DO is a Adolescent Medicine healthcare provider located in FORT LEONARD WOOD, Missouri. NPI 1356300271 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · FORT LEONARD WOOD, MO
Registration Details
- NPI Number
- 1356300271
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 20, 2006 (20.424399485868 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
R9D28 (MO)R9D28 (MO)
Practice Information
- Address
-
126 MISSOURI AVEFORT LEONARD WOOD, MO, 654738952Browse MO providers · Browse ZIP 65473
- Phone
- 5733298305
- Fax
- 5733298302
- Primary Specialty
-
Adolescent Medicine
207QA0505X
- Additional Specialty
- Adolescent Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.