Provider Demographics
NPI:1740253442
Name:HOHMAN, JENNIFER GREENSLADE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:GREENSLADE
Last Name:HOHMAN
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:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-609-1112
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:1479 N RIVER RD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-9760
Practice Address - Country:US
Practice Address - Phone:419-355-9440
Practice Address - Fax:419-355-9443
Is Sole Proprietor?:No
Enumeration Date:2006-02-12
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077157G207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34-1933718OtherTAX ID
OH2243932Medicaid
OH000000301963OtherANTHEM
OH47733OtherCORE SOURCE
OHB77157OtherSUMMACARE
OH4051025OtherMEDICARE
OHP00063419Medicare ID - Type UnspecifiedRAILROAD
OH37600Medicare UPIN
OH2243932Medicaid