Individual
DR. JACK HENRY EBERHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 E 30TH ST, BLDG D-102, FARMINGTON, NM 87401-8990
(505) 327-4429
(505) 327-4420
Mailing address
2300 E 30TH ST, BLDG D-102, FARMINGTON, NM 87401-8990
(505) 327-4429
(505) 327-4420
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
97-223
NM
207YX0602X
Otolaryngic Allergy Physician
Primary
97-223
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R7435
—
NM
Enumeration date
07/06/2006
Last updated
09/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us