Provider Demographics
NPI:1720098577
Name:HARTFORD, JEFFREY FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:FRANCES
Last Name:HARTFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NORTHVIEW
Other - Middle Name:MEDICAL
Other - Last Name:CLINIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:215 E HAWAII AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-6011
Mailing Address - Country:US
Mailing Address - Phone:208-463-3000
Mailing Address - Fax:
Practice Address - Street 1:215 E HAWAII AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-6011
Practice Address - Country:US
Practice Address - Phone:208-463-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM5269207Q00000X
IDM-16687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID003747400Medicaid
IDD72155Medicare UPIN
ID1120685Medicare ID - Type Unspecified