Provider Demographics
NPI:1235121278
Name:PAXTON, JEFF W (MD)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:W
Last Name:PAXTON
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 1:3601 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0002
Mailing Address - Country:US
Mailing Address - Phone:806-743-2848
Mailing Address - Fax:806-743-2122
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:SUITE 1C143
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-8143
Practice Address - Country:US
Practice Address - Phone:806-743-2757
Practice Address - Fax:806-743-2563
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8334207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100228105OtherFIRSTCARE COMMERCIAL
TX100228104Medicaid
TX8008M6OtherBCBS
TX132304008Medicaid
NM37140OtherPRESBYTERIAN COMMERCIAL
NML4243Medicaid
OK100142200AMedicaid
TX132304009Medicaid
NM37140Medicaid
TX85786ZOtherHMO BLUE
NMB005OtherTRIWEST
TX85786ZOtherHMO BLUE
NM37140Medicaid
TX8008M6OtherBCBS