Healthcare Provider Details

I. General information

NPI: 1700657855
Provider Name (Legal Business Name): JEFFREY D OLFERT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 07/24/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 THIRD ST BAYNE-JONES ARMY COMMUNITY HOSPITAL
FORT POLK LA
71459
US

IV. Provider business mailing address

BAYNE-JONES ARMY COMMUNITY HOSPITAL 1585 THIRD ST
FORT POLK LA
71459
US

V. Phone/Fax

Practice location:
  • Phone: 206-550-0456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: