Provider Demographics
NPI:1326337437
Name:BEARFIELD, JEREMY C (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:C
Last Name:BEARFIELD
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9120 DOUBLE DIAMOND PKWY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4842
Mailing Address - Country:US
Mailing Address - Phone:775-204-0150
Mailing Address - Fax:
Practice Address - Street 1:9120 DOUBLE DIAMOND PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4842
Practice Address - Country:US
Practice Address - Phone:775-204-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1326337437Medicaid
NVV107892Medicare PIN