Provider Demographics
NPI:1467454850
Name:MARKLAY, JENNIFER M (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:MARKLAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 WESLEY AVE
Mailing Address - Street 2:STE N
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2298
Mailing Address - Country:US
Mailing Address - Phone:513-841-5520
Mailing Address - Fax:513-841-1580
Practice Address - Street 1:8245 NORTHCREEK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2283
Practice Address - Country:US
Practice Address - Phone:513-745-4706
Practice Address - Fax:513-891-1794
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071536M207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2076793Medicaid
OHMA0864914Medicare PIN
OHG85969Medicare UPIN