Provider Demographics
NPI:1043207483
Name:DENNENY, JAMES CLINTON III (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CLINTON
Last Name:DENNENY
Suffix:III
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:525 N KEENE ST STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6967
Practice Address - Country:US
Practice Address - Phone:573-882-7903
Practice Address - Fax:573-884-4607
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012001985207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN040003145OtherRAILROAD MEDICARE
TN3023690Medicaid
TN3023690Medicaid
TN30236901Medicare PIN