National Provider Identifier Database

THEODORE D FIFER, M.D. FACS – NPI #1508034596
Plastic and Reconstructive Surgery


Contact Information

THEODORE D FIFER, M.D. FACS
14900 N COURT 9
EFFINGHAM, IL62401-7640
Phone: 217-994-6162
Fax: 217-342-7094
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X
Surgery of the Hand 2082S0105X

* Indicates primary specialty

NPI Profile & details for THEODORE D FIFER

NPI Number 1508034596
Credentials M.D. FACS
Entity Individual
Enumeration date 02/13/2008
Last updated 12/12/2012 - About 13 years ago
Sole proprietor1 Yes
Identifiers
  • IL License #: 036084136
  • IL Medicaid: 036-084136
  • IL Other: 025-00076 BLUE CROSS
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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