National Provider Identifier Database

JEFFERY C NORTHUP, DO – NPI #1760595342
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

JEFFERY C NORTHUP, DO
5171 CUB LAKE ROAD
BLDG B SUITE 210
SHOW LOW, AZ85901
Phone: 800-344-8299
Fax: 928-537-4437
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for JEFFERY C NORTHUP

NPI Number 1760595342
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/16/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 Yes
Identifiers
  • AZ License #: 1447
  • AZ Medicaid: 227654-02
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.

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