| Doctor Name: | MR. JEFFERY LYNN INGRAM |
| NPI Number: | 1255650099 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.EEG/EPT, CNIM |
| License Number: | 477 |
| Business Practice Address: | 205 N Park Dr Raymore, MO - 640839186 |
| Business Phone Number: | 6604923841 |
| Business Fax Number: | |
| Mailing Address: | 205 N Park Dr, RAYMORE |
| State: | MO |
| Postal Code: | 640839186 |
| Phone Number: | 6604923841 |
| Fax Number: | |
| NPI Enumeration Date: | 05/19/2010 |
| NPI Last Update Date: | 05/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZE0600X |
| License Number: | 477 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | Electroneurodiagnostic |
| Taxonomy Definition: | |