MEDICARE: JEFFRIES FAMILY MEDICINE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	10123	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720049240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFRIES FAMILY MEDICINE, PLLC

Provider Business Mailing Address
First Line	:	345 CILLEY RD
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-4500
Country	:	US
Telephone Number	:	603-606-6977
Fax Number	:	603-606-6983

Provider Business Practice Location Address
First Line	:	345 CILLEY RD
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-4500
Country	:	US
Telephone Number	:	603-606-6977
Fax Number	:	603-606-6983

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JENNIFER F JEFFRIES
Credential	:	M.D.
Telephone Number	:	603-606-6977

Provider Enumeration Date	:	04/01/2006
Last Update Date	:	02/07/2008

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