Provider Demographics
NPI:1043246523
Name:OVERBEY, JENNIFER KILLION (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KILLION
Last Name:OVERBEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:D
Other - Last Name:KILLION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1085 BEECHER XING N STE A
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4563
Mailing Address - Country:US
Mailing Address - Phone:614-741-8300
Mailing Address - Fax:614-741-8271
Practice Address - Street 1:1085 BEECHER XING N STE A
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-4563
Practice Address - Country:US
Practice Address - Phone:614-741-8300
Practice Address - Fax:614-741-8271
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.082460208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2462124Medicaid
I04160Medicare UPIN
OH000000362328OtherANTHEM BC/BS