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Individual

MICHAEL W JEFFIRS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1160 N STATE ROAD 135, GREENWOOD, IN 46142-1019
(317) 865-6829
Mailing address
9650 E WASHINGTON ST, INDPLS, IN 46229
(317) 890-5548
(317) 890-5619

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002104
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100330840
IN
Enumeration date
09/20/2006
Last updated
10/14/2011
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