Dr. Jack Henry Eberhart
Plastic Surgeon (Head & Neck)
2300 E 30th St Bldg D-102
Farmington
, New Mexico 87401-8990
Dr. Jack Henry Eberhart
Plastic Surgeon (Head & Neck)
2300 E 30th St Bldg D-102
Farmington
, New Mexico 87401-8990
(505) 327-4420
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About
Features
Specialties
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Dr. Jack Henry Eberhart
- 2300 E 30th St Bldg D-102
- Farmington, NM
- Zip : 87401-8990
- Fax : (505) 327-4420
- Phone : (505) 327-4429
Second Address
- Dr. Jack Henry Eberhart
- 2300 E 30th St Bldg D-102
- Farmington, NM
- Zip : 87401-8990
- Fax : (505) 327-4420
- Phone : (505) 327-4429
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207YX0007X | Plastic Surgeon (Head & Neck) | 97-223 | NM |
National Provider Identifier
| NPI | 1215969860 |
|---|---|
| Provider Name | Dr. Jack Henry Eberhart |
| First Address | Farmington, NM 87401-8990 |
| Second Address | Farmington, NM 87401-8990 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/07/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| B09651 | (02) | NM |
| R7435 | (05) | NM |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.