Healthcare Provider Details

I. General information

NPI: 1255330486
Provider Name (Legal Business Name): JENNIFER KAY APPLEYARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 EISENHOWER DR
SAVANNAH GA
31406-2668
US

IV. Provider business mailing address

505 EISENHOWER DR
SAVANNAH GA
31406-2668
US

V. Phone/Fax

Practice location:
  • Phone: 912-354-6190
  • Fax: 912-354-6172
Mailing address:
  • Phone: 912-354-6190
  • Fax: 912-354-6172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number3747
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number3747
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number91503
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: