person
Dr. Jeffrey Cameron Backofen, DO
Military Health Care Provider in Shaw Afb, South Carolina
NPI 1720722473

Jeffrey Cameron Backofen is a Military Health Care Provider based in Hopkins, SC. Jeffrey Cameron Backofen practices in Shaw Afb, SC and has the professional credentials of DO. The NPI Number for Jeffrey Cameron Backofen is 1720722473 and holds a License No. 90973 (South Carolina).

The current practice location address for Jeffrey Cameron Backofen is 420 Polifka Dr Bldg 1042, Shaw Afb, SC and can be reached out via phone at 803-895-6191.

Location: 420 Polifka Dr Bldg 1042, Shaw Afb, SC, 29061-9073
person
Provider Profile Details
NPI Number
1720722473
Provider Name
Jeffrey Cameron Backofen
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
420 Polifka Dr Bldg 1042, Shaw Afb, SC, 29061-9073
Phone Number
803-895-6191
Fax Number
Provider Enumeration Date
04/27/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
420 Polifka Dr Bldg 1042
City
State
Zip
29152-5100
Phone Number
803-895-6191
Fax Number
person
Provider Business Mailing Address Details
Address
420 Polifka Dr Bldg 1042
City
State
Zip
29152-5100
Phone Number
803-895-6191
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
License No.
90973 (South Carolina)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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