Individual
SUSAN JEFFERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3702 AUTOMATION WAY, FORT COLLINS, CO 80525-5737
(970) 922-3630
Mailing address
3702 AUTOMATION WAY, FORT COLLINS, CO 80525-5737
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DR.0064650
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2413945
—
LA
Enumeration date
03/29/2016
Last updated
08/17/2020
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