Provider Demographics
NPI:1053636357
Name:BURKAM, JENNIFER LYNN (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:BURKAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:JACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7420 GOODING BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-7086
Mailing Address - Country:US
Mailing Address - Phone:740-657-8000
Mailing Address - Fax:740-657-8100
Practice Address - Street 1:7420 GOODING BLVD STE 100
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-7086
Practice Address - Country:US
Practice Address - Phone:740-657-8000
Practice Address - Fax:740-657-8100
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.098387208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics