Individual
JEFFREY BLAKE DEBORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
65 HEALTH CARE LN, MARTINSBURG, WV 25401-4006
(304) 263-6997
(304) 263-8827
Mailing address
65 HEALTH CARE LN, MARTINSBURG, WV 25401-4006
(304) 263-6997
(304) 263-8827
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1177
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073644000
—
WV
Enumeration date
10/18/2006
Last updated
09/25/2009
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