Provider Demographics
NPI:1043539950
Name:CLAIBORNE, JEFFREY REID (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:REID
Last Name:CLAIBORNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3401 E CAUSEWAY APPROACH
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-3447
Mailing Address - Country:US
Mailing Address - Phone:985-237-6050
Mailing Address - Fax:985-237-6052
Practice Address - Street 1:3401 E CAUSEWAY APPROACH
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-3447
Practice Address - Country:US
Practice Address - Phone:985-237-6050
Practice Address - Fax:985-237-6052
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA302203208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery