Buedefeldt-Pollard, Jesse Tao

Buedefeldt-Pollard, Jesse Tao is an individual health care provider with primary practice located at 415 N 9Th St Suite 6W100, Springfield IL 62702-5303. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Obstetrics is his primary health care specialty. Buedefeldt-Pollard, Jesse Tao can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
415 N 9Th St Suite 6W100 Springfield IL 62702-5303
Phone: (217) 545-8000
Fax: (217) 545-4912
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD171594 Oregon
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 036140756 Illinois

Profile Details

NPI number 1669768644
LBN Legal business name Buedefeldt-Pollard, Jesse Tao
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2011
Last updated Oct 20th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669768644 NPPES
Illinois MEDICAID 036140756

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