Provider Demographics
NPI:1184656159
Name:ARCHBOLD, JEFFERY T (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:T
Last Name:ARCHBOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:920 W WACKERLY ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2700
Mailing Address - Country:US
Mailing Address - Phone:989-839-9937
Mailing Address - Fax:989-839-9220
Practice Address - Street 1:920 W WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2700
Practice Address - Country:US
Practice Address - Phone:989-839-9937
Practice Address - Fax:989-839-9220
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5105016758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine