Provider Demographics
NPI:1972733244
Name:NOON, JEFFREY THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:THOMAS
Last Name:NOON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N NEW WARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-4247
Mailing Address - Country:US
Mailing Address - Phone:850-456-4788
Mailing Address - Fax:850-456-6066
Practice Address - Street 1:730 N NEW WARRINGTON RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-4247
Practice Address - Country:US
Practice Address - Phone:850-456-4788
Practice Address - Fax:850-456-6066
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6631111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22986VOtherMEDICARE PTAN