Provider Demographics
NPI:1063019289
Name:JEFFIRS, TIMOTHY (PA-C)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:JEFFIRS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10662 12TH RD
Mailing Address - Street 2:
Mailing Address - City:ARGOS
Mailing Address - State:IN
Mailing Address - Zip Code:46501-9551
Mailing Address - Country:US
Mailing Address - Phone:574-936-7273
Mailing Address - Fax:
Practice Address - Street 1:10662 12TH RD
Practice Address - Street 2:
Practice Address - City:ARGOS
Practice Address - State:IN
Practice Address - Zip Code:46501-9551
Practice Address - Country:US
Practice Address - Phone:574-936-7273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical