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NPI Code Detail

MEDICARE: ELIZABETH HUBBARD JEFFORDS M.D.

MEDICARE:   ELIZABETH HUBBARD JEFFORDS  M.D.
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
12084P0804XChild & Adolescent Psychiatry Physician23768SC

General Provider Information

NPI Number : 1891883005
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH HUBBARD JEFFORDS M.D.
Provider Business Mailing Address
First Line : 3710 LANDMARK DR STE 202
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-4034
Country : US
Telephone Number : 803-708-9591
Fax Number : 248-294-1286
Provider Business Practice Location Address
First Line : 3710 LANDMARK DR STE 202
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-4034
Country : US
Telephone Number : 803-908-9591
Fax Number : 248-294-1286
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 11/15/2022

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