Provider Demographics
NPI:1356415012
Name:CLAPPER, JENNIFER R (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:CLAPPER
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 1:254 PALMETTO AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44301-2663
Mailing Address - Country:US
Mailing Address - Phone:330-785-0353
Mailing Address - Fax:
Practice Address - Street 1:6847 N CHESTNUT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-296-9606
Practice Address - Fax:330-296-2005
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-080495207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2422702Medicaid
OHCL7313571Medicare ID - Type Unspecified
OH2422702Medicaid