Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 051238 | GA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 051238 | GA |
NPI | 1033106570 |
---|---|
Provider Name | Dr. Paul R. Jeffords |
First Address | Atlanta, GA 30342-5000 |
Second Address | Atlanta, GA 30342-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 13/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
260597834A | (05) | GA |
260597834B | (05) | GA |
260597834C | (05) | GA |
I10922 | (02) | GA |