Provider Demographics
NPI:1447221890
Name:HAGENSCHNEIDER, JENNIFER K (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:K
Last Name:HAGENSCHNEIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:KAY
Other - Last Name:LEVENGOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5221 US ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2022
Mailing Address - Country:US
Mailing Address - Phone:304-552-1550
Mailing Address - Fax:304-522-1073
Practice Address - Street 1:989 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8750
Practice Address - Country:US
Practice Address - Phone:606-759-3130
Practice Address - Fax:606-759-5259
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0859092085R0202X
WV327152085R0202X
KY399452085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology