Provider Demographics
NPI:1760734651
Name:JEFF R. COMER M.D. P.A.
Entity Type:Organization
Organization Name:JEFF R. COMER M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:R
Authorized Official - Last Name:COMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-939-7274
Mailing Address - Street 1:9738 COMMERCE CENTER CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3670
Mailing Address - Country:US
Mailing Address - Phone:239-939-7274
Mailing Address - Fax:239-939-9091
Practice Address - Street 1:9738 COMMERCE CENTER CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3670
Practice Address - Country:US
Practice Address - Phone:239-939-7274
Practice Address - Fax:239-939-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0038027207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0038027OtherMEDICAL LICENSE