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General NPI Number Information
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NPI Number | 1902829484
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Entity Type | Individual
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Provider Name | EDWARD KENNETH JEFFER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3701 S GEORGE MASON DR 415N
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3758
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Country | US
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Telephone | 703-578-1068
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Fax |
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Provider Business Mailing Address
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Address Line | 3701 S GEORGE MASON DR 415N
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3758
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Country | US
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Telephone | 703-578-1068
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101053378
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 8504
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 14706
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 9900263
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20744
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00019515
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License Number State | AL
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 041143
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G13625
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD0000027749
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License Number State | TN
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Taxonomy #10
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD.11555R
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License Number State | LA
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