Healthcare Provider Details

I. General information

NPI: 1164481263
Provider Name (Legal Business Name): LYDIA M JEFFRIES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 03/12/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MASHBURN MEDICAL CENTER 590 MEDICAL PARK DRIVE
MARSHALL NC
28753-0069
US

IV. Provider business mailing address

163 CHEROKEE RD
ASHEVILLE NC
28804-3801
US

V. Phone/Fax

Practice location:
  • Phone: 828-649-9566
  • Fax:
Mailing address:
  • Phone: 828-777-6321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number32000
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: