Provider Demographics
NPI:1144316506
Name:NAFZIGER, JACOB CALVIN (MD)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:CALVIN
Last Name:NAFZIGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 BALL POND RD E
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-4602
Mailing Address - Country:US
Mailing Address - Phone:614-266-9392
Mailing Address - Fax:
Practice Address - Street 1:COLUMBIA MEMORIAL HOSPITAL
Practice Address - Street 2:71 PROSPECT STREET
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534
Practice Address - Country:US
Practice Address - Phone:518-828-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0540502084P0800X
NY2796722084P0800X
OH350701692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry