Provider Demographics
NPI:1811070808
Name:SCHAFFNIT, JEFFREY CHARLES (USCG CORPSMAN,EMT II)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:CHARLES
Last Name:SCHAFFNIT
Suffix:
Gender:M
Credentials:USCG CORPSMAN,EMT II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LIFESAVER DR APT C
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-9401
Mailing Address - Country:US
Mailing Address - Phone:907-966-2311
Mailing Address - Fax:
Practice Address - Street 1:611 AIRPORT DR
Practice Address - Street 2:MEDICAL DEPT
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-9436
Practice Address - Country:US
Practice Address - Phone:907-966-5469
Practice Address - Fax:907-966-5491
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK05251001146M00000X
171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
Not Answered171000000XOther Service ProvidersMilitary Health Care Provider