Provider Demographics
NPI:1245119254
Name:JEFFERY T. ARCHBOLD, DO, PLLC
Entity type:Organization
Organization Name:JEFFERY T. ARCHBOLD, DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:T
Authorized Official - Last Name:ARCHBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-430-2692
Mailing Address - Street 1:312 E MIDLAND RD STE A
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-9751
Mailing Address - Country:US
Mailing Address - Phone:989-662-8868
Mailing Address - Fax:
Practice Address - Street 1:312 E MIDLAND RD STE A
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9751
Practice Address - Country:US
Practice Address - Phone:989-662-8868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty