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Individual
JEFFERY DEOIN ANGEL
Active
Individual
JEFFERY DEOIN ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C-7451
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114937001
—
AR
01
—
200016406
PALMETTO GBA RAILROAD
AR
01
—
248030
HEALTHLINK
AR
01
—
523277052
MEDICARE - TYPE UNSPECIF
—
01
—
A004
TRICARE
AR
Enumeration date
04/21/2006
Last updated
02/16/2017
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