Individual
JEFFREY S. EARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
324 ROXBURY RD, ROCKFORD, IL 61107-5090
(815) 398-9491
(815) 381-7498
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036133335
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036133335
—
IL
Enumeration date
08/01/2008
Last updated
08/03/2023
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