| Doctor Name: | DR. JEFFREY MICHAEL DIFFENDERFER |
| NPI Number: | 1114249463 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01070055A |
| Business Practice Address: | 36000 Darnall Loop Fort Hood, TX - 765445095 |
| Business Phone Number: | 2542888888 |
| Business Fax Number: | |
| Mailing Address: | 36000 Darnall Loop, FORT HOOD |
| State: | TX |
| Postal Code: | 765445095 |
| Phone Number: | 2542888888 |
| Fax Number: | |
| NPI Enumeration Date: | 02/26/2010 |
| NPI Last Update Date: | 06/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01070055A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |