NPI 1366165763

Moses Joshua Jefferson

Practitioner Contractor Tifton, GA

Practice location

Address: 297 Honeysuckle Ln, Tifton, GA 31794-9179
Phone: (229) 206-2457

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1366165763
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Sep 2022
Record last updated: 21 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.