GLENN E JEFFERSON MD NPI 1326121286

NPI Information

NPI: 1326121286
Provider Name: GLENN E JEFFERSON, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2315 8TH ST
LEWISTON, ID
ZIP 83501
Phone: (208) 746-1383
Get Directions

Glenn E Jefferson, MD is a family medicine in Lewiston, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Glenn E Jefferson, MD NPI is 1326121286. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2315 8TH ST
LEWISTON, ID
ZIP 83501-301
Phone: (208) 746-1383
Fax: (208) 746-6348

The NPI 1326121286 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 3/8/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		MD00025241	WASHINGTON	No
2	207Q00000X	Family Medicine		M4593	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1007806	MEDICAID	WASHINGTON
2	1326121286	OTHER	IDAHO	REGENCE BLUESHIELD OF IDAHO
3	1326121286	OTHER	IDAHO	HEALTHY CONNECTIONS
4	80094289	OTHER	IDAHO	RAILROAD MEDICARE
5	C36977	MEDICARE UPIN	IDAHO
6	G8906558	MEDICARE PIN	WASHINGTON
7	1119637	MEDICARE PIN	IDAHO
8	1326121286	MEDICAID	IDAHO
9	31254	OTHER	WASHINGTON	LABOR & INDUSTRIES
10	DF540	OTHER	IDAHO	BLUE CROSS
11	1119637	OTHER	IDAHO	DMERC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »