Erica M Deford is a Medical in Peoria, Illinois. Erica M Deford practices all healthcare services and medical treatments related to Medical. The NPI Number for Erica M Deford is 1306020334. The last update date is 2009-10-02.
Erica M Deford's current location address is 2805 N Knoxville Ave, Peoria, Illinois. You can contact this provider via phone number 3096249400 and fax number 3096242280. The mailing address for Erica M Deford is 2805 N Knoxville Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Erica M Deford |
|---|---|
| Address | 2805 N Knoxville Ave, Peoria, Illinois |
| Phone Number | 3096249400 |
| Fax Number | 3096242280 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1306020334 |
|---|---|
| Provider Enumeration Date | 2007-12-27 |
| Last Updated Date | 2009-10-02 |
Provider Mailing Address Detail
| Address | 2805 N Knoxville Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616042869 |
| Phone Number | 3096249400 |
| Fax Number | 3096242280 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 85003126 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 809840 | IL | MEDICARE GROUP PTAN | |
| 776530 | IL | MEDICARE GROUP PIN | |
| 37-1221637 | TAX ID |
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What is the Erica M Deford's unique identification number?
The Erica M Deford has been assigned the NPI (National Provider Identifier) Number 1306020334 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Erica M Deford located?
The Erica M Deford is located at 2805 N Knoxville Ave, Peoria, IL 616042869.
What is the area of specialization for Erica M Deford, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Erica M Deford is Medical, and the corresponding taxonomy code that categorizes this area of expertise is 363Am0700X.
When did Erica M Deford receive its 1306020334 assignment?
The Erica M Deford was assigned its 1306020334 on 2007-12-27, which is the date when this unique identifier was issued to the organization.
When was the information related to Erica M Deford most recently updated or refreshed?
The details pertaining to the Erica M Deford, including its address, specialty, and other relevant information, were last updated or refreshed on 2009-10-02.
NPI Number: 1952305922
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