Provider Demographics
NPI:1437148947
Name:JUMPER, CYNTHIA ANN (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:JUMPER
Suffix:
Gender:F
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 27476
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0476
Mailing Address - Country:US
Mailing Address - Phone:806-743-6759
Mailing Address - Fax:806-743-3576
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:4C201
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-9410
Practice Address - Country:US
Practice Address - Phone:806-743-3150
Practice Address - Fax:806-743-3168
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6323207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116311100OtherFIRSTCARE COMMERCIAL
TX130425504Medicaid
NM37965Medicaid
NMA142OtherTRIWEST
NM000F5278Medicaid
TX116311101Medicaid
NM37965OtherPRESBYTERIAN COMMERCIAL
OK100153870AMedicaid
TX130425502Medicaid
TX80757ZOtherHMO BLUE
TX85E054OtherBC/BS
TX130425502Medicaid
TXE93744Medicare UPIN
TX130425504Medicaid