Fifer, Theodore D.
Fifer, Theodore D. is an sole proprietor health care provider with primary practice located at 14900 N Court 9 , Effingham IL 62401-7640. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery of the Hand, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is his primary health care specialty. Fifer, Theodore D. can be contacted via phone (217) 994-6162.Contact Information
Primary practice address
14900 N Court 9
Effingham IL 62401-7640
Phone: (217) 994-6162
Fax: (217) 342-7094
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery of the Hand | 2082S0105X | 036084136 | Illinois |
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 036084136 | Illinois |
Profile Details
NPI number | 1508034596 |
---|---|
LBN Legal business name | Fifer, Theodore D. |
Credentials | M.D. FACS |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 13th, 2008 |
Last updated | Dec 12th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1508034596 | NPPES |
Illinois | MEDICAID | 036-084136 | |
Illinois | Other | 025-00076 |
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