Baltz, Jacob
Baltz, Jacob is an individual health care provider with primary practice located at 3801 S National Ave , Springfield MO 65807. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Baltz, Jacob can be contacted via phone (417) 269-6583.Contact Information
Primary practice address
3801 S National Ave
Springfield MO 65807
Phone: (417) 269-6583
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 2003009184 | Missouri |
Profile Details
| NPI number | 1174519821 |
|---|---|
| LBN Legal business name | Baltz, Jacob |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Dec 27th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174519821 | NPPES |
| Missouri | MEDICAID | 208792200 | |
| Missouri | MEDICAID | 1174519821 |
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