Provider Demographics
NPI:1245265354
Name:JEFFCOAT, CAROLYN HESS (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:HESS
Last Name:JEFFCOAT
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 1:847 EASTON RD
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2906
Mailing Address - Country:US
Mailing Address - Phone:215-918-5555
Mailing Address - Fax:
Practice Address - Street 1:847 EASTON RD
Practice Address - Street 2:SUITE 2500
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2906
Practice Address - Country:US
Practice Address - Phone:215-918-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2001-01560207Q00000X
PAMD452946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891341AMedicaid
SCN01560Medicaid
NC891341AMedicaid
NC2016887BMedicare PIN
NCH85483Medicare UPIN
NC2016887AMedicare PIN