Provider Demographics
NPI:1730158296
Name:JEFFERS, ELAINE T (DC)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:T
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 NEW ORLEANS RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-4777
Mailing Address - Country:US
Mailing Address - Phone:843-842-7575
Mailing Address - Fax:843-842-7676
Practice Address - Street 1:14 NEW ORLEANS RD
Practice Address - Street 2:SUITE 4
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4777
Practice Address - Country:US
Practice Address - Phone:843-842-7575
Practice Address - Fax:843-842-7676
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2233111N00000X
KY3745111N00000X
CO2022111N00000X
OH968111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2233Medicaid
SCU055190282Medicare PIN
SCCH2233Medicaid