Provider Demographics
NPI:1215175625
Name:TEFFT, PAMELA A (OPTICIAN)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:A
Last Name:TEFFT
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8211 BELL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-2532
Mailing Address - Country:US
Mailing Address - Phone:812-853-3606
Mailing Address - Fax:812-853-3625
Practice Address - Street 1:8211 BELL OAKS DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2532
Practice Address - Country:US
Practice Address - Phone:812-853-3606
Practice Address - Fax:812-853-3625
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician