JEFFERY CARLETON NORTHUP DO NPI 1760595342

NPI Information

  • NPI: 1760595342
  • Provider Name: JEFFERY CARLETON NORTHUP, DO
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 5171 CUB LAKE ROAD
    BLDG B SUITE 210
    SHOW LOW, AZ
    ZIP 85901
  • Phone: (800) 344-8299

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NPI Details

Jeffery Carleton Northup, DO is a specialist in Show Low, AZ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Jeffery Carleton Northup, DO NPI is 1760595342. 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:

5171 CUB LAKE ROAD
BLDG B SUITE 210
SHOW LOW, AZ
ZIP 85901
Phone: (800) 344-8299
Fax: (928) 537-4437

The enumeration date for this NPI number is 8/16/2006 and was last updated on 7/8/2007.

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
1174400000XSpecialist1447ARIZONAYes

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
1E20686MEDICARE UPINARIZONA
2D01447AMEDICARE ID-TYPE UNSPECIFIEDARIZONA
3227654-02MEDICAIDARIZONA

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: 3/30/2025

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