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NPI Code Detail

MEDICARE: DR. ROBERT GORDON JEFFERS MD

MEDICARE: DR. ROBERT GORDON JEFFERS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080A0000XPediatric Adolescent Medicine Physician26274NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659341048
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT GORDON JEFFERS MD
Provider Business Mailing Address
First Line : 2406 BLUE RIDGE RD
Second Line : SUITE 100
City : RALEIGH
State : NC
Zip : 27607-6678
Country : US
Telephone Number : 919-786-5001
Fax Number : 919-786-5051
Provider Business Practice Location Address
First Line : 2406 BLUE RIDGE RD
Second Line : SUITE 100
City : RALEIGH
State : NC
Zip : 27607-6678
Country : US
Telephone Number : 919-786-5001
Fax Number : 919-786-5051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 07/08/2007

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