Provider Demographics
NPI:1558523415
Name:SEMORE, JENNIFER JANE (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JANE
Last Name:SEMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:CRUMLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-470-2590
Mailing Address - Fax:405-470-0619
Practice Address - Street 1:9417 N COUNCIL RD STE 200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6207
Practice Address - Country:US
Practice Address - Phone:405-470-2590
Practice Address - Fax:405-470-0619
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK28143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine