Provider Demographics
NPI:1679352744
Name:ROBARE, JEFFORY SCOTT
Entity Type:Individual
Prefix:
First Name:JEFFORY
Middle Name:SCOTT
Last Name:ROBARE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6441 FARMDALE RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1305
Mailing Address - Country:US
Mailing Address - Phone:304-453-4992
Mailing Address - Fax:
Practice Address - Street 1:6441 FARMDALE RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1305
Practice Address - Country:US
Practice Address - Phone:304-453-4992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant