Provider Demographics
NPI:1093765802
Name:BAIR, JEFFREY F (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:F
Last Name:BAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 E BROWN ST
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301
Mailing Address - Country:US
Mailing Address - Phone:570-421-3872
Mailing Address - Fax:570-424-6631
Practice Address - Street 1:239 E BROWN ST
Practice Address - Street 2:MEDICAL ASSOC OF MONROE COUNTY
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301
Practice Address - Country:US
Practice Address - Phone:570-421-3872
Practice Address - Fax:570-424-6631
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028692E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABA70590OtherBCBS
PA0009895250001Medicaid
PA070590ECNMedicare ID - Type Unspecified
D71121Medicare UPIN