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Individual

DR. TABATHA L. JEFFERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6470
(814) 375-3472
Mailing address
825 TREASURE LK, DU BOIS, PA 15801-9017
(814) 375-0460
(814) 375-3472

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS-010759-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001608234
HIGHMARK BLUE CROSS
PA
05
0019508010002
PA
Enumeration date
08/09/2006
Last updated
01/28/2015
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