Provider Demographics
NPI:1003904467
Name:KIEFER, JOSEPH E (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:KIEFER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 N 9TH AVE.
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4535
Mailing Address - Country:US
Mailing Address - Phone:850-434-9867
Mailing Address - Fax:850-434-9878
Practice Address - Street 1:1851 N 9TH AVE.
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4535
Practice Address - Country:US
Practice Address - Phone:850-434-9867
Practice Address - Fax:850-434-9878
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 1874213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL593567914OtherTAX ID
FL65020OtherBLUE CROSS BLUE SHIELD
FL5088270001Medicare NSC
FL480007421Medicare PIN
FLK1790Medicare PIN
FLT94329Medicare UPIN