MEDICARE: DR. BARBARA L 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
1	207Q00000X	Family Medicine Physician	234476	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1770584138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA L JEFFERS MD

Provider Business Mailing Address
First Line	:	1237 SAWMILL RD
Second Line	:
City	:	ORISKANY FALLS
State	:	NY
Zip	:	13425-3840
Country	:	US
Telephone Number	:	315-821-6157
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 LA RIVIERE DR STE 201
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14202-4036
Country	:	US
Telephone Number	:	716-893-1010
Fax Number	:	716-893-1002

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/08/2023

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