Individual
DOUGLASS ALAN JEFFERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4020 PALMER PARK BLVD STE 101B, SUITE 109, COLORADO SPRINGS, CO 80909-3433
(719) 577-9977
(719) 577-9911
Mailing address
4020 PALMER PARK BLVD STE 101B, COLORADO SPRINGS, CO 80909-3433
(719) 577-9977
(719) 577-9911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
324
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
324
STATE LICENSE
CO
05
—
54358221
—
CO
01
—
811342
MEDICARE PPTAN
CO
Enumeration date
12/13/2006
Last updated
03/07/2023
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