Provider Demographics
NPI:1962420976
Name:HARBAUGH, JENNIFER REGAN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:REGAN
Last Name:HARBAUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:REGAN
Other - Last Name:REGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:112 HOSPITAL LN
Mailing Address - Street 2:STE 200
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1998
Mailing Address - Country:US
Mailing Address - Phone:740-642-4400
Mailing Address - Fax:740-642-4407
Practice Address - Street 1:610 BLACKWATER RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9003
Practice Address - Country:US
Practice Address - Phone:740-642-4400
Practice Address - Fax:740-642-4407
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01086635A207V00000X
OH35.069483207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2055645Medicaid
OHG77157Medicare UPIN
OH2055645Medicaid