Individual
MARK S JEFFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7740 WASHINGTON VILLAGE DR, SUITE 120, CENTERVILLE, OH 45459-4056
(937) 433-8020
(937) 433-8030
Mailing address
7740 WASHINGTON VILLAGE DR, SUITE 120, CENTERVILLE, OH 45459-4056
(937) 297-8999
(937) 433-8030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34006895
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000695157
ANTHEM BCBS
OH
05
—
2081938
—
OH
Enumeration date
09/21/2005
Last updated
03/07/2023
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