Provider Demographics
NPI:1659535060
Name:JEFFRIES, TERRY E (PA-C)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:E
Last Name:JEFFRIES
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:501 S CHIPETA WAY
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 S CHIPETA WAY
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1222
Practice Address - Country:US
Practice Address - Phone:801-581-7952
Practice Address - Fax:801-585-2949
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2016-12-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant