Provider Demographics
NPI:1326080821
Name:NEUHAUSER, JEFFREY LEE (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:LEE
Last Name:NEUHAUSER
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 WASHINGTON BLVD STE 103
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-4001
Practice Address - Country:US
Practice Address - Phone:419-673-8689
Practice Address - Fax:567-295-6892
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH53383207Q00000X
IN01054276A207Q00000X
OH35053383207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0620644Medicaid
OHA16390Medicare UPIN
INA16390Medicare UPIN
OH0581675Medicare PIN
IN090430CCCCMedicare ID - Type Unspecified
OHH306720Medicare PIN