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Individual
DR. JEFFREY A FEARON
Active
Individual
DR. JEFFREY A FEARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,F.A.C.S.
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
H8638
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E1668
—
MN
01
—
00X682
MEDICARE GROUP PTAN
TX
01
—
0722264
IOWA MEDICAID
IA
05
—
093725201
—
TX
05
—
10010045
—
TX
05
—
118956501
—
TX
05
—
118956502
—
TX
05
—
1921297
—
LA
05
—
208847509
—
MO
05
—
3858
—
TX
01
—
5542707
AETNA
TX
01
—
86J892
BC/BS PROVIDER ID NUMBER
TX
01
—
8F5212
MEDICARE INDIVIDUAL PTAN
TX
05
—
91863803
—
CO
Enumeration date
05/22/2006
Last updated
02/16/2017
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