Healthcare Provider Details

I. General information

NPI: 1144316506
Provider Name (Legal Business Name): JACOB CALVIN NAFZIGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 BALL POND RD E
NEW FAIRFIELD CT
06812-4602
US

IV. Provider business mailing address

36 BALL POND RD E
NEW FAIRFIELD CT
06812-4602
US

V. Phone/Fax

Practice location:
  • Phone: 614-266-9392
  • Fax:
Mailing address:
  • Phone: 614-266-9392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number279672
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number054050
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: