Provider Demographics
NPI:1417940339
Name:SIEFKER, JOSEPH DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DANIEL
Last Name:SIEFKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 MAR WALT DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6645
Mailing Address - Country:US
Mailing Address - Phone:850-796-1368
Mailing Address - Fax:850-796-2368
Practice Address - Street 1:1032 MAR WALT DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6645
Practice Address - Country:US
Practice Address - Phone:850-796-1368
Practice Address - Fax:850-796-2368
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93776207YX0007X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Not Answered207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy