NPI 1801692462

Wendall Keith Jefferson

Practitioner Contractor Phenix City, AL

Practice location

Address: 1719 12th St, Phenix City, AL 36867-6044
Phone: (404) 307-5251

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1801692462
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Feb 2025
Record last updated: 22 Mar 2025

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.