Dr. Jack Henry Eberhart, MD
Otolaryngology, Otolaryngic Allergy in Farmington, NM. Individual provider (NPI-1).
NPI number1215969860
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1215969860
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jack Henry Eberhart
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 6, 2006
- Last updated
- Sep 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207YX0602X | Otolaryngology, Otolaryngic Allergy | 97-223 | NM | Yes |
| 207YX0007X | Otolaryngology, Plastic Surgery within the Head & Neck | 97-223 | NM |
Practice location
2300 E 30th StBldg D-102
Farmington, NM 87401-8990
Phone 505-327-4429 · Fax 505-327-4420
Mailing address
2300 E 30th StBldg D-102
Farmington, NM 87401-8990
Phone 505-327-4429 · Fax 505-327-4420
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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