Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME127626 | FL |
NPI | 1821039397 |
---|---|
Provider Name | Dr. Jeffrey Alan Paffrath |
First Address | Lakeland, FL 33805-3019 |
Second Address | Lakeland, FL 33805-3109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 27/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G69268 | (02) | TN |