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Contact Information

JEFFREY D NEIDHART, MD
2325 E 30TH ST
FARMINGTON, NM87401-8900
 Phone: 505-564-6850
 Fax: 505-564-6890
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JEFFREY D NEIDHART · (Male)

NPI # 1801972518
Status Active
Credentials MD
Entity Individual
Enumeration date 10/27/2006
Last updated 06/24/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 2002-0176
  • AZ Medicaid 764086
  • CO Medicaid 93002840
  • NM Medicaid 38022222
  • UT Medicaid T0445
  • NM Other NM019A39 BLUE CROSS OF NEW MEXICO
Hospital affiliation(s)
  • MERCY REGIONAL MEDICAL CENTER - (Acute Care)
    1010 THREE SPRINGS BLVD
    DURANGO, CO 81301
  • SAN JUAN REGIONAL MEDICAL CENTER - (Acute Care)
    801 WEST MAPLE STREET
    FARMINGTON, NM 87401
  • SOUTHWEST MEMORIAL HOSPITAL - (Critical Access)
    1311 N MILDRED RD
    CORTEZ, CO 81321
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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