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General NPI Number Information
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NPI Number | 1417940339
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Entity Type | Individual
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Provider Name | JOSEPH DANIEL SIEFKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1032 MAR WALT DR SUITE 100
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6645
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Country | US
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Telephone | 850-796-1368
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Fax | 850-796-2368
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Provider Business Mailing Address
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Address Line | 1032 MAR WALT DR SUITE 100
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6645
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Country | US
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Telephone | 850-796-1368
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Fax | 850-796-2368
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | ME93776
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number | ME93776
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License Number State | FL
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