Organization
JEFFERY S CANTRELL MD PA
Active
Organization
JEFFERY S CANTRELL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY S CANTRELL MD (MD)
(972) 420-1776
Entity
Organization
Contact information
Practice address
2960 LONG PRAIRIE RD, FLOWER MOUND, TX 75022-4845
(972) 420-1776
(972) 221-8685
Mailing address
PO BOX 977, LEWISVILLE, TX 75067-0977
(972) 420-1776
(972) 221-8685
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
H6092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0070QP
BLUESHIELD PROVIDER #
TX
Enumeration date
04/16/2008
Last updated
04/16/2008
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