Individual
DR. JEFFREY D NEIDHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2325 E 30TH ST, FARMINGTON, NM 87401-8900
(505) 564-6850
(505) 564-6890
Mailing address
PO BOX 1799, FARMINGTON, NM 87499
(505) 564-6850
(505) 564-6890
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2002-0176
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38022222
—
NM
05
—
764086
—
AZ
05
—
93002840
—
CO
01
—
NM019A39
BLUE CROSS OF NEW MEXICO
NM
05
—
T0445
—
UT
Enumeration date
10/27/2006
Last updated
06/24/2021
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