Individual
LYDIA R JEFFCOAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 WALLACE BASHAW WAY, SUITE 2003, NEWBURYPORT, MA 01950-3875
(978) 465-0635
(978) 465-0941
Mailing address
1 WALLACE BASHAW WAY, SUITE 2003, NEWBURYPORT, MA 01950-3875
(978) 465-0635
(978) 465-0941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
80924
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110055616A
—
MA
Enumeration date
09/21/2006
Last updated
08/13/2012
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