Provider Demographics
NPI:1265439269
Name:MCCARTNEY, JEFFREY JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOHN
Last Name:MCCARTNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JEFFREY
Other - Middle Name:J
Other - Last Name:MCCARTNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11190 HEALTH PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-5729
Mailing Address - Country:US
Mailing Address - Phone:239-552-7222
Mailing Address - Fax:239-552-7690
Practice Address - Street 1:11190 HEALTH PARK BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5729
Practice Address - Country:US
Practice Address - Phone:239-552-7222
Practice Address - Fax:239-552-7690
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00392052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068443100Medicaid
FL068443100Medicaid
FL592269071OtherPIN
D58875Medicare UPIN