Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | F6783 | TX |
N | 208200000X | Surgeon | F6783 | TX |
N | 208600000X | Surgeon | F6783 | TX |
NPI | 1568422772 |
---|---|
Provider Name | Dr. Gregory John Jaffers |
First Address | Temple, TX 76508 |
Second Address | Temple, TX 76508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 03/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020047407 | RR/MEDICARE (01) | TX |
1227464-02 | CSHCN (01) | TX |
1227464-03 | (05) | TX |
83X693 | BLUE SHIELD (01) | TX |
B23725 | (02) | TX |