MEDICARE: ALINA 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	207V00000X	Obstetrics & Gynecology Physician	47657	MN

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	:	1902870678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALINA JEFFERS MD

Provider Business Mailing Address
First Line	:	6525 FRANCE AVE S
Second Line	:	PAUL LARSON OB GYN CLINIC STE 100
City	:	EDINA
State	:	MN
Zip	:	55435-3624
Country	:	US
Telephone Number	:	952-927-4021
Fax Number	:	952-285-6183

Provider Business Practice Location Address
First Line	:	6525 FRANCE AVE S
Second Line	:	PAUL LARSON OB GYN CLINIC STE 100
City	:	EDINA
State	:	MN
Zip	:	55435-3624
Country	:	US
Telephone Number	:	952-927-4021
Fax Number	:	952-285-6183

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	03/19/2014

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