Provider Demographics
NPI:1679675235
Name:GREENFIELD, JEFFREY R (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:GREENFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 CLEARWATER DRIVE
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-8209
Mailing Address - Country:US
Mailing Address - Phone:207-781-7900
Mailing Address - Fax:707-575-5509
Practice Address - Street 1:98 CLEARWATER DRIVE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-8209
Practice Address - Country:US
Practice Address - Phone:207-781-7900
Practice Address - Fax:707-575-5509
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8555204D00000X, 207Q00000X
CA20A13504204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHE96442Medicare UPIN
CAE96442Medicare UPIN