Provider Demographics
NPI:1194137349
Name:KNEPPAR, JENNIFER LEIGH (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH
Last Name:KNEPPAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:464 HILLSIDE AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-1227
Mailing Address - Country:US
Mailing Address - Phone:617-754-0748
Mailing Address - Fax:
Practice Address - Street 1:5354 REYNOLDS ST STE 424
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6011
Practice Address - Country:US
Practice Address - Phone:912-819-5999
Practice Address - Fax:912-819-5980
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA079665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine