Provider Demographics
NPI:1558155572
Name:KIFER, JONATHAN JR
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:KIFER
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 PARKWOOD DR APT C
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1350
Mailing Address - Country:US
Mailing Address - Phone:336-792-8907
Mailing Address - Fax:
Practice Address - Street 1:1114 EASTCHESTER DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3114
Practice Address - Country:US
Practice Address - Phone:336-802-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician