MEDICARE: ROBERT JEFFRIES MD

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	207W00000X	Ophthalmology Physician	MD104152	MO
2	207W00000X	Ophthalmology Physician	C8269	AR

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	:	1740275775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JEFFRIES MD

Provider Business Mailing Address
First Line	:	3602 W SOUTHERN HILLS BLVD
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8013
Country	:	US
Telephone Number	:	479-631-8900
Fax Number	:	479-899-6698

Provider Business Practice Location Address
First Line	:	3602 W SOUTHERN HILLS BLVD
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8013
Country	:	US
Telephone Number	:	479-631-8900
Fax Number	:	479-899-6698

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	08/28/2024

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