Provider Demographics
NPI:1083677397
Name:CONNER, JENNIFER L (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:CONNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1725 WESTERN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1345
Mailing Address - Country:US
Mailing Address - Phone:419-423-4994
Mailing Address - Fax:419-423-3326
Practice Address - Street 1:1725 WESTERN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1345
Practice Address - Country:US
Practice Address - Phone:419-423-4994
Practice Address - Fax:419-423-3326
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2010-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35069452207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2067418Medicaid
OH2067418Medicaid
OHG62161Medicare UPIN