Provider Demographics
NPI:1013981414
Name:SAWYER, JENNY K (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:K
Last Name:SAWYER
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 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:330-954-7210
Mailing Address - Fax:330-954-7211
Practice Address - Street 1:55 N CHILLICOTHE RD STE 100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8799
Practice Address - Country:US
Practice Address - Phone:330-954-7210
Practice Address - Fax:330-954-7211
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073079S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2203850Medicaid
OH2203850Medicaid
OHSA0881321Medicare PIN