Provider Demographics
NPI:1184661373
Name:NAEF, ROBERT WILLIAM III (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:NAEF
Suffix:III
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 1:501 MARSHALL ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-1651
Mailing Address - Country:US
Mailing Address - Phone:601-360-5651
Mailing Address - Fax:601-360-5661
Practice Address - Street 1:501 MARSHALL ST
Practice Address - Street 2:SUITE 601
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-1651
Practice Address - Country:US
Practice Address - Phone:601-948-6540
Practice Address - Fax:601-326-1501
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11758207VM0101X
AL18032207VM0101X
CO36719207VM0101X
LA12709R207VM0101X
TN39259207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1542865Medicaid
AL000027555Medicaid
CO27826317Medicaid
MS7068048OtherAETNA
MS05026733Medicaid
MSF87827Medicare UPIN
LAB-62854Medicare ID - Type Unspecified
MS7068048OtherAETNA
CO27826317Medicaid