Healthcare Provider Details

I. General information

NPI: 1477411825
Provider Name (Legal Business Name): JOSEPH PATRICK JEFFERIES NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 WALTON WAY
AUGUSTA GA
30901-2612
US

IV. Provider business mailing address

1417 DOOLEY LN
GROVETOWN GA
30813-8314
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-9011
  • Fax:
Mailing address:
  • Phone: 850-348-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP309681
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: