Healthcare Provider Details

I. General information

NPI: 1780693499
Provider Name (Legal Business Name): JENNIFER LYNN HUGGINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 12/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVENUE ML 4010
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVENUE ML 4010
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-803-0649
  • Fax: 513-636-4116
Mailing address:
  • Phone: 513-803-0649
  • Fax: 513-636-4116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number35.087099
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number35.087099
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.087099
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: