Provider Demographics
NPI:1770893547
Name:JEFFREY W GEFTER M.D., P.C.
Entity type:Organization
Organization Name:JEFFREY W GEFTER M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:GEFTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-756-0018
Mailing Address - Street 1:979 E 3RD ST
Mailing Address - Street 2:SUITE G-20
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-756-0018
Mailing Address - Fax:423-265-2045
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:SUITE G-20
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-756-0018
Practice Address - Fax:423-265-2045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN141832085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3051052Medicaid