Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 07001198A | IN |
NPI | 1003178690 |
---|---|
Provider Name | Jeffrey Hassel Eifler |
First Address | Chicago, IL 60613-3618 |
Second Address | Elkhart, IN 46514-3968 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 25/09/2015 |