Individual provider · Type 1 NPI
Jack Fennel, DO
Adult Medicine Physician · Fort Leonard Wood, MO
NPI number
1356300271
Active
Practice location
126 Missouri Ave
Fort Leonard Wood, MO 65473-8952
Fax (573) 329-8302
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | R9D28 (MO) |
| Adult Medicine Physician Primary | 207QA0505X | R9D28 (MO) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
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- Amber Michelle Hall, LPNLicensed Practical Nurse Fort Leonard Wood, MO NPI 1891002002
- Amy Leanne Prater, RNRegistered Nurse Fort Leonard Wood, MO NPI 1881900041
- Angela Beth Wyatt, BSNCommunity Health Registered Nurse Fort Leonard Wood, MO NPI 1932184009
- Angela KaysLicensed Practical Nurse Fort Leonard Wood, MO NPI 1679873509
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About NPI 1356300271
Jack Fennel, DO's National Provider Identifier is 1356300271, issued on Mar 20, 2006. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Fort Leonard Wood, MO. The record was last updated on Jul 13, 2026.