Provider Demographics
NPI:1306824362
Name:LONGACRE, JEFFREY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LEE
Last Name:LONGACRE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4301 JONES BRIDGE RD
Mailing Address - Street 2:A1029
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4712
Mailing Address - Country:US
Mailing Address - Phone:301-295-1917
Mailing Address - Fax:301-295-1960
Practice Address - Street 1:4301 JONES BRIDGE RD
Practice Address - Street 2:A1029
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4712
Practice Address - Country:US
Practice Address - Phone:301-295-1917
Practice Address - Fax:301-295-1960
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2011-02-09
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Provider Licenses
StateLicense IDTaxonomies
MDD66287208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics