Provider Demographics
NPI:1376050781
Name:JENSEN, SAVANNAH LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:LEIGH
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SAVANNAH
Other - Middle Name:LEIGH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:421 HOPKINS ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45203-1429
Mailing Address - Country:US
Mailing Address - Phone:615-509-6518
Mailing Address - Fax:
Practice Address - Street 1:421 HOPKINS ST APT 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45203-1429
Practice Address - Country:US
Practice Address - Phone:615-509-6518
Practice Address - Fax:615-509-6518
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57246026207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine