National Provider Identifier Database

JACK H EBERHART, MD – NPI #1215969860
Otolaryngic Allergy


Contact Information

JACK H EBERHART, MD
2300 E 30TH ST
BLDG D-102
FARMINGTON, NM87401-8990
Phone: 505-327-4429
Fax: 505-327-4420
Website:
Specialty Taxonomy Code
* Otolaryngic Allergy 207YX0602X
Plastic Surgery within the Head & Neck 207YX0007X

* Indicates primary specialty

NPI Profile & details for JACK H EBERHART

NPI Number 1215969860
Credentials MD
Entity Individual
Enumeration date 07/06/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 No
Identifiers
  • NM License #: 97-223
  • NM Medicaid: R7435
Hospital affiliation n/a

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.

Reviews for JACK H EBERHART, MD

There are currently no reviews for JACK H EBERHART, MD


NPIdb - Home
v2.201