DR. JEFFREY MICHAEL DIFFENDERFER (NPI# 1114249463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114249463 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY MICHAEL DIFFENDERFER |
| Credential | MD, MPH |
| Practice Address |
4301 Wilson St Fort Sill OK 73503 |
| Mailing Address |
377 Nw Bay Dr Elgin OK 73538-3062 |
| Practice Telephone | 3019089140 |
| Mailing Telephone | 3019089140 |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2018-05-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
01070055A | IN | Allopathic & Osteopathic Physicians |
| Y | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
01070055A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
4301 WILSON ST |
| City | FORT SILL |
| State | OK |
| Zip Code | 73503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154323301 | Brenda K Swain | Nurse Practitioner | 4301 Wilson St, Ent Clinic, Fort Sill, OK 73503-4472 | 2005-06-01 |
| 1073148342 | Jonathan Kline | Physician Assistant | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2020-03-07 |
| 1205474947 | Karyn Zaage | Physical Therapist | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2019-12-12 |
| 1063059715 | Holley Ann Martinez | Technician, Other | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2019-12-02 |
| 1174168165 | Michele Hornsby | Physician Assistant | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2019-11-13 |
| 1831732346 | Kaegan G Williams | Physician Assistant | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2019-10-28 |
| 1144870015 | Kaylee Johnson | Physical Therapist | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2019-09-12 |
| 1245889591 | Scott Michael Hallak | Physical Therapist | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2019-09-10 |
| 1104472471 | Adriana Ramos | Social Worker | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2019-08-13 |
| 1275185001 | Joshua Robert Jenny | Physician Assistant | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2019-07-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824446 | Alex Boyd | Dentist | U.S.A. Dental Health Activity, 652 Hamilton Road, Fort Sill, OK 73503 | 2020-06-01 |
| 1588145031 | Dustin Davis | Dentist | Usa Dental Health Activity 652 Hamilton Rd., Fort Sill, OK 73503 | 2018-08-23 |
| 1578086492 | Austin Kent Brown | Dentist | Usa Dental Activity 652 Hamilton Rd., Fort Sill, OK 73503 | 2017-07-23 |
| 1083155998 | Michael Gagliano | Physician Assistant | 4301 Wilson Street, Attn: Mcua-qm Credentials, Reynolds Army Health Clinic, Fort Sill, OK 73503 | 2017-03-10 |
| 1619428885 | Kristi Ann Putnam | Registered Nurse | Sgt Bleak Troop Medical Clinic, 6039 Berry Street, Fort Sill, OK 73503 | 2016-10-21 |
| 1003265901 | Lucy Muller | Registered Nurse | 4301 Wilson Road, Ft Sill, OK 73503 | 2016-06-10 |
| 1356740146 | Gregory B Kiene | Dentist | 642 Hamilton Rd, Usa Dental Activity, Fort Sill, OK 73503 | 2014-08-18 |
| 1295152262 | Cheryl Marie Wildman | Dental Assistant | 2640 Miner Road, Weeks Dental Clinic, Ft Sill, OK 73503 | 2014-03-27 |
| 1245664143 | Tina L Gray | Dentist | 652 Hamilton Road, Suite 210, Fort Sill Dentac, Fort Sill, OK 73503 | 2013-08-27 |
| 1720410533 | Katherine Loi | Dentist | 652 Hamilton Rd, Fort Sill Dentac, Suite 210, Fort Sill, OK 73503 | 2013-08-02 |
| Find all providers in zip 73503 | ||||
| Taxonomy Code | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093341224 | Mosaic Medical Foundation West Okc | Preventive Medicine | 1139 N Meridian Ave, Oklahoma City, OK 73107-5095 | 2020-03-19 |
| 1629494000 | Lee Ann Schafer | Preventive Medicine | 1027 E 66th St N, Tulsa, OK 74126-1349 | 2014-03-10 |
| 1164709598 | Whitney Anne Johnson | Preventive Medicine | 107 E Anderson Ave, Waurika, OK 73573-3008 | 2011-11-14 |
| 1417120023 | Robert Luther Swicord | Preventive Medicine | 14300 N Pennsylvania Ave, # 57, Oklahoma City, OK 73134-6066 | 2008-04-04 |
| 1851509236 | Gary Lloyd Massad | Preventive Medicine | 7501 N Country Club Drive, Oklahoma City, OK 73116 | 2007-05-18 |
| 1558489385 | Stephen P. Klassen | Preventive Medicine | 6101 W Reno Ave, Suite 800, Oklahoma City, OK 73127-6542 | 2007-03-27 |
| 1366560104 | John W. Hallford Jr. | Preventive Medicine | 5682 W Skelly Dr, Tulsa, OK 74107-9144 | 2007-03-27 |
| 1730204975 | William C Parsons | Preventive Medicine | 310 S Keeler, B-fptc Medical, Bartlesville, OK 74004-0001 | 2007-03-20 |
| 1245361500 | Jeffrey Paul Pardee | Preventive Medicine | 1006 Sw 104th St, Oklahoma City, OK 73139-2990 | 2007-03-08 |
| 1891825337 | Debra Lea Montgomery | Preventive Medicine | 1500 W I 240 Service Rd, Oklahoma City, OK 73159-8209 | 2007-03-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.