Provider Demographics
NPI:1063118487
Name:EHRHART, JEFFREY (MS)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:EHRHART
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 N MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-1108
Mailing Address - Country:US
Mailing Address - Phone:800-406-5143
Mailing Address - Fax:231-775-4556
Practice Address - Street 1:1909 N MITCHELL ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-1108
Practice Address - Country:US
Practice Address - Phone:800-406-5143
Practice Address - Fax:231-775-4556
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist