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DR. JACK HENRY EBERHART MD
NPI 1215969860
Otolaryngology - Otolaryngic Allergy in Farmington, NM

Active since July 06, 2006
2300 E 30TH ST, BLDG D-102, FARMINGTON, NM 87401(505) 327-4429(505) 327-4420 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jack Henry Eberhart Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK HENRY EBERHART MD (NPI 1215969860) is an individual otolaryngic allergy provider in Farmington, New Mexico, licensed in New Mexico (97-223) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1215969860
Entity TypeIndividualMale
Primary Taxonomy207YX0602X
Provider Legal NameDR. JACK HENRY EBERHARTCredential: MD
Location Address2300 E 30TH ST, BLDG D-102Farmington, NM 87401-8990
Mailing Address2300 E 30th St, Bldg D-102Farmington, NM 87401-8990 · (505) 327-4429 · Fax (505) 327-4420
Phone(505) 327-4429
Fax(505) 327-4420
Sole ProprietorNo
Enumeration DateJuly 6, 2006
Last NPPES UpdateSeptember 11, 2025
✔ NPI 1215969860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngology · Otolaryngic AllergyAllopathic & Osteopathic Physicians
Taxonomy Code207YX0602X
License✔ Licensed in NM · 97-223
Definition
An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases.
Also ListedOtolaryngology · Plastic Surgery within the Head & NeckTaxonomy 207YX0007X · License 97-223 (NM)
2300 E 30TH ST, Farmington, NM 87401
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Other Identifiers 1

MedicaidR7435NM

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID LEE WILKEY MD
Otolaryngology (Otolaryngic Allergy)
2300 E 30TH ST, BLDG D-102
FARMINGTON, NM 87401
San Juan County (505) 327-4429
SEAN FAHERTY MD
Family Medicine
2300 E 30TH ST, BLDG B, STE 102
FARMINGTON, NM 87401
San Juan County (505) 324-1000
JULIE SCHAEFER PA-C
Physician Assistant
2300 E 30TH ST, BLDG B, SUITE 102
FARMINGTON, NM 87401
San Juan County (505) 324-1000
R STEPHEN RANKIN MD
Pediatrics
2300 E 30TH ST, BLDG C2
FARMINGTON, NM 87401
San Juan County (505) 324-1000
DR. SCOTT D ALLEN MD
Ophthalmology
2300 E 30TH ST, STE 105
FARMINGTON, NM 87401
San Juan County (505) 327-0406
ANNETTE RANDLEMON CNP
Nurse Practitioner (Family)
2300 E 30TH ST, BLDG B, SUITE 102
FARMINGTON, NM 87401
San Juan County (505) 324-1000
DR. JAMES F BURPEE M.D.
Urology
2300 E 30TH ST, BLDG B SUITE 106
FARMINGTON, NM 87401
San Juan County (505) 327-9111
SAN JUAN REGIONAL MEDICAL CENTER INC
Psychiatry & Neurology (Neurology)
2300 E 30TH ST, BUILDING 102
FARMINGTON, NM 87401
San Juan County (505) 609-6790

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Eberhart's NPI number?

The NPI number for Jack Eberhart is 1215969860. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is Jack Eberhart located?

Jack Eberhart practices at 2300 E 30th St Bldg D-102, Farmington, NM 87401. The listed phone number is (505) 327-4429.

What is Jack Eberhart's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngic Allergy, with taxonomy code 207YX0602X.

When was this NPI record last updated?

The NPPES record for Jack Eberhart was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.