DR. Fanasy Prokop Jefcoat, D.M.D., MS
NPI #1154401909 in Madison, Mississippi
Provider Information
- NPI Number
- 1154401909
- Entity Type
- Individual
- Name
- DR. Fanasy Prokop Jefcoat, D.M.D., MS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - Periodontics
- Credential
- D.M.D., MS
- Enumeration Date
- Oct 16, 2006
- Last Updated
- Feb 7, 2017
Practice Location
- Address
- 101 WEBSTER CIRCLE
- Address 2
- SUITE 100
- City
- Madison
- State
- Mississippi
- ZIP Code
- 39110
- Phone
- (601) 605-6511
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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