Provider Demographics
NPI:1679898068
Name:CLEMENTS, JENNIFER JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JEAN
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20463 GEORGIA HIGHWAY 144
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-5850
Mailing Address - Country:US
Mailing Address - Phone:770-580-9291
Mailing Address - Fax:
Practice Address - Street 1:20463 GEORGIA HIGHWAY 144
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-5850
Practice Address - Country:US
Practice Address - Phone:770-580-9291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTW-000302083B0002X
FL1531702083B0002X
AZ661712083B0002X
MO20130260722083B0002X
NE347342083B0002X
VA01012702242083B0002X
MT1072772083B0002X
AL439142083B0002X
CO0015532083B0002X
UT12703104-12052083B0002X
SCMD835032083B0002X
WI2049-3202083B0002X
GA756632083B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine