Provider Demographics
NPI:1740689165
Name:JEFFREY C. MARKHAM, MD, PA
Entity type:Organization
Organization Name:JEFFREY C. MARKHAM, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED REP
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-270-4100
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-0362
Mailing Address - Country:US
Mailing Address - Phone:877-887-1784
Mailing Address - Fax:877-682-5167
Practice Address - Street 1:3305 CORINTH PKWY
Practice Address - Street 2:ATRIUM MEDICAL CENTER
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76208-5380
Practice Address - Country:US
Practice Address - Phone:940-270-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM53522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty