Provider Demographics
NPI:1114185014
Name:FRENCH, JEFFERY TED
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:TED
Last Name:FRENCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 JACKSON BLVD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-1501
Mailing Address - Country:US
Mailing Address - Phone:605-342-5902
Mailing Address - Fax:
Practice Address - Street 1:2218 JACKSON BLVD
Practice Address - Street 2:SUITE 2A
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-1501
Practice Address - Country:US
Practice Address - Phone:605-342-5902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD216237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9151400Medicaid