Hostetler, Jacob

Hostetler, Jacob is an sole proprietor health care provider with primary practice located at 4602 Us Highway 59 , Grove OK 74344-4229. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hostetler, Jacob can be contacted via phone (918) 877-1211.

Contact Information

Primary practice address
4602 Us Highway 59 Grove OK 74344-4229
Fax: (918) 877-1216
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 31475 Oklahoma

Profile Details

NPI number 1265829485
LBN Legal business name Hostetler, Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2015
Last updated Nov 13th, 2022 - about 2 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 1265829485 NPPES
Oklahoma MEDICAID 200659910B

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