Provider Demographics
NPI:1124091095
Name:CANTER, JEFFREY NOEL (PA-C)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:NOEL
Last Name:CANTER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2240
Mailing Address - Country:US
Mailing Address - Phone:541-463-2358
Mailing Address - Fax:
Practice Address - Street 1:600 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2240
Practice Address - Country:US
Practice Address - Phone:541-463-2358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA202279208VP0000X, 363A00000X
CAPA16612363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical