Provider Demographics
NPI:1174799837
Name:KEFER, JOHN CHRISTOPHER (MD PHD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:KEFER
Suffix:
Gender:M
Credentials:MD PHD
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Other - Credentials:
Mailing Address - Street 1:4743 ARAPAHOE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1113
Mailing Address - Country:US
Mailing Address - Phone:303-444-9000
Mailing Address - Fax:303-444-9073
Practice Address - Street 1:4743 ARAPAHOE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1113
Practice Address - Country:US
Practice Address - Phone:303-444-9000
Practice Address - Fax:303-444-9073
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2014-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO49212208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1174799837Medicare UPIN