Provider Demographics
NPI:1699890954
Name:HARPER, JENNIFER MADGE (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MADGE
Last Name:HARPER
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 1:1305 HEMBREE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3810
Mailing Address - Country:US
Mailing Address - Phone:678-762-9494
Mailing Address - Fax:678-762-9496
Practice Address - Street 1:1305 HEMBREE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3810
Practice Address - Country:US
Practice Address - Phone:678-762-9494
Practice Address - Fax:678-762-9496
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0310142083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA031014OtherGEORGIA MEDICAL LICENSE
GA031014OtherGEORGIA MEDICAL LICENSE